
Glass 



J? C si 



Book 1J t f 



COPYRIGHT DEPOSIT 



THE HOME 
PRACTICE OF MEDICINE 



WITH 

249 pages o?i General Diseases 
20 pages 011 Hygienic Methods 
45 pages on Diseases of Women 
38 pages 011 Diseases of the Skin 
71 pages on Piles, Fistula* Fissures, and 
Other Diseases of the Rectum, illustrated 
by most Beautiful Chromo-lithograph En- 
gravings and Woodcuts 



BY 

/ 

JOHN WESLEY DAILY, A.B., M.D. 

Formerly Field Surgeon with the Fifteenth Regiment of the United 
States Infantry; Surgeon of the General Field Hospital, At- 
lanta, Georgia; Surgeon of the General Hospital at Chatta- 
nooga; Surgeon of the General Ci.ay Hospital, Louisville; 
Surgeon of Camp Douglas Hospital at Chicago; Visiting 
Surgeon for a Year in the Hospitals of Europe; 
and for Years a Physician and Surgeon of a 
Private Hospital of Boston, Massachusetts 



THE DAILY PUBLISHING COMPANY 

596 Tremont Street 

BOSTON, MASS. 

1899 



TWO COPIES RECEIVED 
Offjc; 



Raster of CpyHrfU -CJ 



49426 

Copyright, 1898, 
By THE DAILY PUBLISHING COMPANY. 

Copyright 1899 
By John Wesley Daily. 



SECOND COPY, 



J. S. Cushing & Co. - Berwick & Smith 
Norwood Mass. U.S.A. 






MY BROTHER, DR. S. J. DAILY 

To whom I am indebted for the able article on "Heredity"; 
who has also rendered me other valuable assistance in prepar- 
ing this work for publication ; who was a surgeon in various 
hospitals during the Civil War ; who was with me, as surgeon, 
in the General Clay Hospital, Louisville ; the General Field 
Hospital, Atlanta ; the General Hospital, Chattanooga ; and who 
has been my companion in sickness, danger, and distress, 

&hts 33oofc is EKfottonatelg Bctftcatefc 

BY THE AUTHOR 



PREFACE 

TO 

THE SECOND EDITION. 

As a " Home Practice of Medicine " this book is in- 
tended to meet the wants of the people as no other work 
has ever done. 

It gives unfailing treatments for more than one-half of 
the usual diseases ; is written in a clear and condensed 
style ; is freed from difficult and confusing medical terms ; 
and deals with the ailments of mankind in the language 
of human experience — the people's experience. 

It devotes seventy-one pages to Piles, Fistula, Fissures, 
Falling of the Rectum, and Itching Piles ; describes all 
these diseases as fully and clearly as possible ; tells their 
usual causes ; how to prevent them ; and how to arrest 
their development. 

It also gives the methods for curing Piles, Fistula, and 
Fissures without cutting ; without the use of ether or 
chloroform ; without clamp, cautery, or scissors ; with but 
little if any pain ; and, usually, without loss of time from 
business. 

While every page is as plain and definite as language 
can be, " Diseases of the Rectum and Anus " are made 
doubly clear by the finest chromo-lithograph engravings 
and woodcuts that ever adorned the pages of a medical 
work. 

If the book only contained sure methods of treatment 
for ten diseases, — cholera infantum, membranous croup, 
diphtheria, dysentery, aciUe rheumatism, pneicmonia, dys- 

5 



6 PREFACE. 

pepsia, sick headache, cramp colic, and catarrh, — its worth 
could never be estimated in dollars, because no one can 
place a moneyed value upon life, health, and human love. 

The work is intended to separate the known and reliable 
from the unknown and experimental, and to give facts and 
advice that will bring joy to the hearts of millions in times 
of sickness and danger. 

The prescriptions have all been written in plain English, 
and everything that is mind-confusing and time-wasting 
has been left out. 

The habit of giving mixtures containing many drugs has 
always been confusing to physicians, has prevented valu- 
able discoveries in medicine, and just as long as it lasts 
will be a clog upon the wheels of progress. 

The use of one remedy to cure many diseases is far more 
reliable than the use of many remedies to cure one disease. 

A portion of the work is devoted exclusively to "female 
diseases," including the signs of pregnancy, the manage- 
ment of the pregnant state, and the effects of the mother's 
mind upon her unborn child. 

Another part is exclusively upon "skin diseases," and 
gives sure methods of treatment for over half the affec- 
tions of the skin, including eczema in all its many forms, 
such as salt-rheum, tetter, scall-head, and scrofulous disease 
of the scalp. It also gives a never-failing treatment for acne, 
a disease through which so many young people of both 
sexes are ruined in personal appearance by unsightly pim- 
ples upon the face. 

The treatment leaves the skin sound, by entirely remov- 
ing the pimples ; the red color soon fades, and the face 
becomes smooth, fair, and natural. 



IMPORTANT EXPLANATIONS. 



As this book is intended for the general public, every 
chapter, including all the prescriptions, has been written 
in plain English. 

The work has not been brought out to save the money 
that is usually paid to doctors, but to save life and suffering. 

When a star is found before the name of a disease in 
the index, it means that the chapter devoted to that affec- 
tion gives a method of treatment that is practically sure to 
cure it. 

In discovering modes of treatment that are sure to cure 
over forty diseases, the author wishes every one to know 
that success frequently depends more upon the proper use 
of food and drink than upon drugs. 

In some diseases there is nothing capable of doing so 
much harm as water, while in others, there is nothing can 
do so much good. 

The writer's success in cholera infantum, and almost all 
diseases attended with sickness of the stomach and diar- 
rhoea, depends largely upon measuring and limiting the 
amount of fluid taken by the patient. 

In cholera infantum there is nothing kills so many chil- 
dren as the reckless use of water, and strange as it may 
seem, the quickest way to reduce the thirst is to limit the 

7 



8 IMPORTANT EXPLANATIONS. 

water to a teaspoonful every half hour, and this should 
always be measured, as guesswork will not answer in such 
cases. 

In almost all diarrhoeas there is constant thirst, which the 
patient tries to control by drinking from a half to a pint of 
water at a time, and this increases the diarrhoea and the 
thirst also. 

There are no drugs that will control diarrhoea under such 
management, and the quickest and surest plan of treatment 
is to limit the amount of liquid to a tablespoonful every 
half hour for adults, and a teaspoonful for children. 

When this plan is conjoined with the drug treatment as 
advised in the book, the sickness and diarrhoea will subside 
in fifteen hours and the desire for water will gradually cease. 

Ice, for the purpose of allaying thirst, is one of the worst 
things that ever went into the month of a sick pei'son, as the 
reaction following its use is so great as to cause a burning 
thirst that nothing but more ice will satisfy, a7id in a few 
hours the stomach is full of water, and sickness and diarrhoea 
follow. 

In the treatment of fevers, provided there is no sickness 
and diarrhoea, water, both internally and externally, is fre- 
quently of the utmost importance ; but in all diseases com- 
plicated with sickness and diarrhoea, water and other liquids 
should be limited to teaspoonful doses for children, and 
tablespoonfuls for adults until the trouble subsides. 

In inflammatory rheumatism the patient should drink all 
the water he can. In all acute inflammations of joints, 
muscles, membranes, or organs of the body, the inflamed 
structures should be kept in a state of perfect rest, if pos- 
sible, until the inflammatory condition is overcome. 

Dyspepsia is found to exist more or less in connection 



IMPORTANT EXPLANATIONS. 9 

with a great many diseases, and should always be treated 
in accordance with the advice given in the chapter upon 
"atonic dyspepsia." 

There are a great many maladies due to a common cause, 
and yet are very unlike in their symptoms ; for example : 
neuralgia, sick headache, common headache, cramp colic, 
common colic, insomnia, dyspepsia, melancholy, palpitation 
of the heart, and, usually, constipation of the bowels, are 
all due to a partial nervous exhaustion, and are all treated 
upon one general principle, and mainly with one drug — 
the extract of ignatia. 

As some of the above diseases are found to exist with a 
vast number of human ailments, and as ignatia always cures 
them, that drug is prescribed in a great many chapters in 
the book. 

It surely seems more logical to give one remedy for a 
multiplicity of diseases, provided it cures them all, than it 
is to give a multiplicity of remedies for one disease and 
guess at results. 

The reason that ignatia cures so many affections is, that 
they are all due to a common cause — nervous debility. 

In almost all inflammatory affections of an acute charac- 
ter, an arterial sedative, such as tincture of veratrum or 
aconite, should be given as early as possible in the disease. 

There are three diseases — cholera infantum, diphtheria, 
and membranous croup — in either one of which a delay of 
one hour may prove fatal to a little patient. 

Every family with children liable to these diseases should 
alzuays keep a box of powders for cholera infantum, a bottle 
of medicine to apply to the throat in diphtheria, and a bottle 
of the syrup for membranous croup. 

I11 cholera infantum, if the powders are given as directed, 



10 IMPORTANT EXPLANATIONS. 

and the amount of liquid is limited to a teaspoonful every 
half hour, every child can be saved. 

In membranous croup, if the remedy advised in the book 
is given as soon as the attack sets in, and the sickness is 
kept up for several hours, every case will recover, as the 
sickness will arrest the formation of the membrane. 

hi diphtheria, if the throat is properly treated as soon 
as the white patches are seen, the disease will be overcome 
in twenty-four hours. 

In the treatment of over forty diseases for which this work- 
gives methods of treatment that are reasonably sure to cure, 
but very few disappointments will occur if all the directions 
are carefully followed. 



THE 

HOME PRACTICE OF MEDICINE. 



>>*Kc 



HYGIENE. 

It seems that one of the most important chapters of 
any medical book intended for the general public, is one 
devoted to those principles and habits of life that relate to 
health and longevity. To know how to keep well and 
carry the health-tinted cheeks and youthful vigor across 
and beyond the meridian of life's journey, is one of the 
most interesting problems that concerns mankind. 

It is not necessarily the frosts of many winters that 
make us old, nor is it altogether the weight of years 
through which we are depressed and bowed down. Those 
who recklessly abandon themselves to all manner of ex- 
cesses, are soon bereft of health and forced to join the 
silent majority before reaching the natural noon time of 
life. Others, wisely aware that only a certain amount 
of enjoyment can be crowded into the brief span of indi- 
vidual existence, live model lives, and keenly enjoy health 
and happiness at the age of eighty. 

If the sporting class that lead intemperate lives by in- 
dulging in all kinds of dissipation, are truly the wicked 
people of the world, then that old and sometimes abused 
book uttered an approximate truth in saying, " The wicked 

ii 



12 HYGIENE. 

do not live out half their days." But the maxim, " Ephraim 
is joined to idols, let him alone," applies as well to the 
sporting class of our time as it did to a similar class two 
thousand years ago ; and therefore this article will not be 
turned into a temperance lecture in order to reform those 
who have hopelessly abandoned themselves to the allure- 
ments of vice. Saint Paul struck the keynote of hygiene 
when he said in his letter to Timothy, " Be temperate in 
all things," as there is not a solitary pleasure that mankind 
enjoys that may not become a blighting bane to happiness 
when its indulgence is carried to excess. 

The main question under consideration is, what to do 
and what not to do in order to escape disease. There 
is nothing surer than this : If every organ of the body is 
kept in a natural, healthy condition, and stimulants and 
excesses of every kind are avoided, the individual is in the 
finest possible state to resist disease. 

As one of the most important factors connected with 
the maintenance of a healthy organism is the avoidance of 
stimulants, the subject of alcohol in its many forms and 
of tea and coffee, all of which act as a spur to the nervous 
system, deserves special attention. 

There is nothing in the universe superior to nature — 
nothing that can rise above it. When a man is in a state 
of health, he is in the enjoyment of everything, so far as a 
healthy, vigorous body is concerned, that any power can 
give. To give him a stimulant, is to lash his entire 
organism into exerting, for a limited time, undue energies. 
There are only three conditions, as regards the natural, in 
which a man can exist : First, the normal, or natural ; 
second, the subnormal, which is below the natural ; and, 
third, the supernormal, which is for a limited time above 



TEA AND COFFEE. 1 3 

the natural. There is only one way by which to force the 
human system into a supernormal condition, and that is 
by a stimulant. What follows ? Let us see. One of the 
eternal principles in the economy of nature is, that a cor- 
responding degree of depression always follows the exhil- 
arating effect of a stimulant. For example : If a stimulant 
raises the energy of the organism twenty-five per cent 
above the normal, it will certainly fall twenty-five per 
cent below the normal when the effect of the stimulant 
ceases; and, what is more, the stage of depression will be 
fully as long as that of the exaltation. The above being the 
effect of a stimulant, what good can it accomplish under 
such circumstances? None whatever. Does it do any 
harm ? It certainly does. Anything that interferes with 
nature and changes the functions of the physical body from 
the natural to the unnatural, can do nothing but harm. 

TEA AND COFFEE. 

These two drugs are intensely stimulating to the nervous 
system, and the harm they are capable of doing when 
used as beverages, depends, first, upon the quantity taken, 
and second, upon the temperament of the individual. The 
following is an exact quotation from the United States 
Dispensatory, a standard work on the preparation and 
action of drugs : " Coffee, if taken in large quantities, 
leaves, after its first effect, a degree of nervous derange- 
ment or depression equivalent to the previous excitement ; 
and its habitual employment is well known to injure the 
tone of the stomach, and frequently to occasion trouble- 
some dyspeptic and nervous affections. This effect is 
peculiarly apt to take place in persons of susceptible ner- 



14 TEA AND COFFEE. 

vous systems and in those of sedentary habits. We have 
repeatedly known patients who have suffered with headache 
and vertigo to get rid of them by abstaining from coffee." 

The action of tea upon the nervous system is very 
similar to that of coffee, and like the latter, is liable to 
cause wakefulness when taken at night ; but owing to the 
delicious taste and fascinating odor of coffee, it is used 
twenty times as much as tea and therefore capable of do- 
ing that much more harm to mankind. 

The author, in devoting a great deal of time and study 
to a large number of diseases associated with dyspepsia and 
largely depending upon it, had occasion to study closely 
the causes of chronic indigestion, a disease known to doc- 
tors by the familiar name of " atonic dyspepsia." There 
is scarcely anything more obvious to the intelligent reader 
than this : that any drug having the power, when taken in 
moderate quantity for a limited time, to favorably stimulate 
digestion, also has the power to ruin digestion when taken 
in large quantities, or during a long period of time in less 
quantities. A knowledge of these facts caused the author 
twenty-five years ago to put a close watch upon coffee 
as a leading factor in causing dyspepsia and its great train 
of associated diseases. 

The manner in which coffee enfeebles digestion and 
develops those obstinate dyspeptic conditions, such as sick 
headache, painful colics, constipation, hypochondria, insom- 
nia, and many other maladies, seems to be as clear as a 
cloudless noonday, and it is hoped it will be equally clear 
to the reader. The eternal principle that should govern 
and limit the use of all stimulants is this : A correspond- 
ing period of depression always follows the exhilarating 
effect of a stimulant. 



TEA AND COFFEE. 1 5 

If a strong cup of coffee is taken at breakfast, a feeling 
of moderate and rather pleasant excitement lasts almost 
until the next meal. For this reason dyspeptics who limit 
their coffee drinking to the morning meal, have but little 
trouble, comparatively, in digesting that meal, because the 
nervous system that presides over the digestive functions, 
is under a constant spur for hours. By noon, however, 
the stimulant has died out and a state of depression in 
which the nervous energy drops as far below the natural 
as the coffee raised it above, is established. 

Before taking the coffee, the man is in a normal or nat- 
ural condition. For hours after taking it, he is in a super- 
normal or unnaturally excited state, and by dinner time, 
when the stimulant has given out, he is in a subnormal or 
depressed state. From the foregoing it seems evident that 
any stimulant that forces the digestive system to the exer- 
cise of undue energies, in order to digest the morning 
meal, impairs the power of the stomach and bowels to 
digest the subsequent meals of the day. Unfortunately 
for mankind, coffee drinkers do not limit themselves to 
one or two cups at breakfast, but drink it at the other 
meals as well. Let us see what results from the constant 
use of a nervous stimulant of any kind. The muscular 
system when forced to work too hard or too long, gets 
tired and sooner or later becomes exhausted. The same 
is true, exactly the same, of the nervous system, and a 
stimulant like coffee bears about the same relation to the 
nerves that the lash of the task master of the South did 
to the muscles of the slaves in the cotton fields, and there- 
fore, if coffee is taken three times a day or even once per 
day in large quantity, a state of partial nervous exhaus- 
tion is almost sure to follow, and with it one of the worst 
forms of dyspepsia imaginable. 



1 6 EFFECT OF STIMULANTS. 

In such cases the disease is called " atonic dyspepsia," 
as atony means debility, and is caused by nervous debility. 
A better term would be coffee dyspepsia, as it is essen- 
tially different in many respects from dyspepsia from other 
causes. One of the most distressing characteristics of 
coffee dyspepsia is the frequent and terrible headaches 
that accompany it, especially the " sick headache." 

It is well to state in this connection that most all coffee 
drinkers suffer from headache more or less, and usually 
the trouble is moderate or severe, according to the amount 
of coffee taken. 

EFFECT OF STIMULANTS UPON THE DIF- 
FERENT ORGANS OF THE BODY. 

Under the influence of an excitant, the brain and nerves 
work harder, the stomach secretes more juices, digestion 
is more complete, the liver secretes more bile, the pancreas 
more pancreatic juice, the \idneys more urine, the peri- 
staltic or worm-like action * the bowels is increased, the 
heart beats faster, the lu' gs nil and empty themselves 
quicker, the state of general vitality is higher, and the 
individual actually lives faster and wears out quicker than 
he otherwise would ; but the most unhappy effect of a gen- 
eral stimulant is, that after its action ceases, every organ 
of the body drops down to a sluggish or subnormal state 
and waits to be aroused by another stimulant. A physic 
is usually a local stimulant or irritant, and when used for 
constipation, is as irrational as it is harmful. The bowels 
become accustomed to its use and simply wait for it. 

Before the horse cars were taken from Tremont Street, in 
the city of Boston, it was found hard for the teams to pull 



TOBACCO. 17 

a car filled with passengers up one of the steepest grades. 
In all such cases the car had to wait until an electric car 
came up behind and boosted it over the hill. The horses 
soon learned that the electric car would do the work for 
them, and therefore they would wait at the foot of the 
grade until they could hear the buzzing of the electric 
wheels, before they would offer to pull. This illustrates 
a principle that runs through the entire animal economy, 
namely : That every physical organ when stimulated for 
any length of time, becomes blunted in its susceptibility 
to the natural nerve forces and waits for an artificial exci- 
tant. As constipation is treated at length in a chapter 
devoted especially to that subject, it cannot be considered 
further in this connection than to say this : Never take 
physic for constipation. If you do, the bowels will drop 
into the habit of waiting for it, and in that way your 
trouble will gradually increase. 

There is a natural diminution of nervous intensity as 
shown in its effect upon most of the organs as one passes 
from childhood to adult life, and therefore a general ten- 
dency to constipation as we grow older. For this reason 
anything that has an intrinsic tendency to dull or lessen 
the susceptibility of the bowels to a nerve force that is 
gradually diminishing as the frosts of other winters come 
upon us, should be carefully avoided. - 

TOBACCO. 

This "weed " is used by millions and millions of people, 
and is condemned by almost every one, including those 
who use it. Its active principle consists mainly of nicotin 
and a volatile oil — empyreumatic oil. Strong tobacco con- 



1 8 SMOKING. 

tains from five to eight per cent of nicotin, which is a 
deadly poison. Tobacco, like alcohol, is an active stimu- 
lant in its primary effect, while its secondary action is that 
of a prostrating sedative, especially if carried to the point 
of producing sickness of the stomach. The most harmful 
way in which tobacco is ever used is by chewing. In 
addition to the fact that tobacco chewing is disgustingly 
filthy, that the chewer is compelled to be spitting con- 
stantly, that his breath is extremely offensive, and the 
spittoon is a foul, odor-breeding thing that is not fit to be 
in any parlor, the drug often has a terrible effect upon the 
nervous system and organs of digestion. Almost all of 
the so-called heartburn from which tobacco chewers suffer, 
is from tobacco. The tendency of tobacco chewing, even 
when it does not seriously impair the general health, is to 
reduce the flesh from ten to fifteen per cent. For exam- 
ple : A person whose normal weight is one hundred and 
fifty pounds before using tobacco in this way, will drop off 
from fifteen to twenty pounds from its continued use. A 
forced reduction of flesh from tobacco, anti f at, or any 
other drug, is almost always at the sacrifice of health and 
vitality. 

SMOKING. 

The first effect of a cigar or a pipe is to quicken the 
heart's action and maintain, during the smoking hour and 
for some little time after, a supernormal condition of the 
nervous system. Since the nerve forces are spurred by 
the " weed " to an unnatural intensity, it is often claimed 
by the friends of the pipe and cigar that smoking after 
meals favorably affects digestion. But it must ever be 
remembered that the nervous system is capable of exer- 



SMOKING. 19 

cising a certain definite force, and that any artificial means 
employed to develop a physical force that does not actu- 
ally exist, is at the sacrifice of enduring energy. There is 
nothing in man superior to himself, nothing that can rise 
above his natural organic forces. If he could be hastened 
in his speed like a locomotive, only using a drug instead 
of steam, he would at once cease to be a physical being 
and become a machine. Tobacco, in all the forms in 
which it is used, belongs to the catalogue of stimulants, 
and, like alcohol, tea, and coffee, quickens the heart's 
action and forces the entire body into a condition that is 
supernormally energetic for a limited time, to be followed 
by a corresponding period of depression. It is not possible 
for an unnatural stimulant — and all drug stimulants are 
unnatural — to raise the average energy of the nervous 
system the thousandth part of a unit. The only effect of 
stimulants is to make the human organism run irregularly, 
somewhat like a Kansas windmill, that only runs when 
the wind blows. 

While tobacco is a depressing and devitalizing agent, 
and while smoking, chewing, and snuff rubbing are all 
debilitating, it must be admitted that some persons estab- 
lish a perfect tolerance for the drug and use it during a 
long life with impunity. 

A discharging ulcer upon the body is a constant drain 
upon the system, and yet nature arouses her energies, in 
many cases, so as to supply an extra amount of recupera- 
tive power to support the ulcer and a healthy and vigorous 
organism. It is probable that through the elastic and 
conservative principles of nature the otherwise disastrous 
effects of the tobacco habit are occasionally overcome and 
health and longevity maintained. 



20 DIET. 

A century ago, a pseudo-philosopher, ignorant of the 
principle that action and reaction are equal, placed a great 
bellows in the stern of his sailing-boat, in order to blow 
against the sails and make fair headway during a dead calm. 
As part of the artificial breeze went wide of the mark 
and was wasted, the action was less than the reaction, and 
the craft moved in the wrong direction, that is, backwards. 
And so it will ever be with every man who attempts to 
force himself into an unnatural gait by using stimulants. 
He will go in the wrong direction. 

The recoil of a gun is always equal to the force of the 
discharge in the other direction, and whenever a man can 
escape the recoil of a stimulant, that eternal principle of 
nature, that action and reaction are equal, will be destroyed, 
and men will be able to lift themselves over the fence by 
their own bootstraps. 

DIET. 

There seems to be some excuse for the maxim : " One 
man's meat is another man's poison," as some persons are 
distressed by almost everything they eat, while others eat 
with impunity anything they can swallow, and for this reason 
no absolute rule can be given for the guidance of persons 
in a state of health except this : Every man should use 
those articles of food that he has found by long and care- 
ful experience best suited to his particular case as regards 
comfortable digestion, regularity of the bowels, and the 
maintenance of a vigorous body. 

The treatment of constipation by coarse bread and other 
articles of rough food is to a great extent a failure, as it 
is a physic in disguise and acts by irritating the lining 
membranes of the stomach and bowels. 



DIET. 21 

As the health and comfort of almost every individual 
depend upon the regular movement of the bowels, the 
subject of constipation has to be considered to some extent 
in connection with diet, as the dietetic treatment of the 
trouble in connection with other hygienic measures is the 
one upon which every person must mainly depend. 

The best treatment that the author has ever known for 
constipation is a fruit diet. It consists in the abandon- 
ment to a great extent of meat, and eating fish, bread and 
butter, and an abundance of fruits and vegetables. 

The reason that fruits often fail to overcome constipa- 
tion is, that the fruit regime is not rigidly carried out. 
Eating an apple now and then when one happens to feel 
apple-hungry, or taking an orange at bedtime, does no 
good. If three or four fair-sized apples are eaten raw 
during the day and suitable fruits and vegetables taken at 
meals, the bowels will soon begin to move easily and will 
gradually, except in the very worst cases, get to moving 
every day. Fruits containing seeds like raspberries and 
blackberries are bad and should not be eaten by persons 
subject to constipation. The same is true of grapes if the 
seeds are swallowed. A great many cases of fatal appen- 
dicitis are caused by swallowing such seeds. The use of 
powdered magnesia as a physic is equally dangerous, as it 
is liable to cause obstinate obstruction if not appendicitis. 

Apples, peaches, oranges, plums, and lemons are the 
best fruits to be eaten. When the peach season is over, 
the best dried peaches, when properly stewed, are calcu- 
lated to favor a natural action of the bowels. Prunes are 
simply half-dried plums, and are also good, but inclined 
to act like a physic and cause griping pains when eaten 
in excessive quantities. They are fine, however, to eat 



22 CLOTHING. 

in connection with other fruits. While the fruit diet is 
being followed, such articles as cheese and eggs and such 
others as are known to be constipating, should be avoided. 

CLOTHING. 

When the writer of a medical book brings forward ideas 
in regard to clothing or anything else that are in open 
conflict with the established customs of the people, he is 
called a crank or fanatic. The author has not sought 
to popularize this work by catering to the pet notions of 
any one, but, on the other hand, has tried to point out 
many of the customs of living that are radically and 
deplorably wrong. One of the greatest mistakes of this 
generation, especially among the rich, is the habit of 
clothing children so warmly that proper exercise in the 
open air during the winter season is almost impossible. 

When a boy is fettered with overshoes, and then wrapped 
up from his throat to his feet, almost, with an overcoat, he 
doesn't run to school as is natural with children, but walks 
and acts like a man. In many cases such boys are ad- 
monished never to go out of the schoolroom without over- 
shoes and overcoat. He cannot indulge in any games or 
romps with boys that are properly clad, because he cannot 
run. He suffers for want of the vigorous thrill of the 
heart and arteries that childhood ever demands, and for 
want of which physical development is impeded. 

Such boys are usually slender, with soft, flabby muscles, 
are decidedly effeminate when fully matured, and not very 
strong intellectually. They correspond to the " feather- 
bed soldiers " of the late war. In childhood the heart 
beats a third faster than in adult life, the breathing is 



THE SKIN. 23 

faster, the vitality naturally greater, much more physical 
heat is generated, and the power to resist cold much 
greater, and therefore they do not need the clothing that 
men and women do. The muscular and organic systems 
must be developed during adolescence, — during the main 
period of physical and mental growth, — and anything 
that seriously impedes the motion of the body seriously in- 
terferes with proper development. 

THE SKIN. 

This is one of the most extensive and also one of the 
most important organs of the body. It covers and pro- 
tects the veins and capillaries and also various glands. It 
is intensely endowed with nerve fibres, and is therefore a 
highly sensitive organ. This seems to be a wise provision 
of nature, as the skin, being an immense envelope enclos- 
ing the human body and exquisitely sensitive in every 
part, is practically a force of sentinels guarding the indi- 
vidual while he sleeps. 

Any one who has ever been aroused from sweet and 
pleasing dreams by a bedbug meandering over his body 
at midnight, can realize how wonderfully sensitive the skin 
is. The membranes lining the cavities of the body are a 
continuation of the skin, and, like the latter, are depurating 
organs, or, in plainer terms, organs through which innu- 
merable poisonous elements are eliminated from the body. 
The skin is endowed with a multiplicity of glands of two 
kinds, — sweat glands and oil glands. The latter are at the 
roots of the hair and contribute to hair nourishment and 
growth. The sweat glands exist in some parts of the skin 
to the number of two thousand or more to the square 



24 THE SKIN. 

inch, and rising from them like church spires, are little 
tubes or ducts that conduct the water from the secreting 
glands to the surface of the skin. These tubes are known 
by the common name of " pores," and the water that they 
bring to the surface under the name of " sweat," or " insen- 
sible perspiration," gradually evaporates, and in doing so, 
lowers the temperature of the body. 

In this way persons are protected from the otherwise 
insufferable heat of summer. The amount of water given 
off by the skin reaches, in rare cases, a half gallon in 
twenty-four hours. That is called " sweating " or " per- 
spiring," but when the amount of water exhaled by the 
skin is only a pint or a little more, it is called " insensible 
perspiration." 

It is said — and the statement seems reasonable — that 
if a coat of varnish be applied to the entire skin, that a 
person would almost perish from ordinary summer heat, 
as in that case no water could come out of the " pores " 
and lower the heat of the body by evaporation. All these 
things teach the importance of keeping the skin in a clean, 
healthy condition so the sweat ducts will not be closed. 
This leads us up to the subject of bathing. 

As to how often a person of ordinary vigor and strength 
of body should bathe, is a question not easily answered, 
as a great deal depends upon occupation. Coal diggers 
bathe every night, year in and year out when working. 
With them it is a necessity, and they are exceedingly 
healthy. The question, How often should a person bathe ? 
can only be answered one way, and that is this : Often 
enough to keep clean. 



EXERCISE. 25 



EXERCISE. 

It is one of the immutable principles of nature that 
every physical organ that is not used, gradually becomes 
atrophied or shrunken greatly in size so as to be worthless. 
If a leg or arm is tied up for years and not used, muscular 
atrophy or shrinking away of the muscles takes place, and 
that member of the body becomes forever useless; and if 
some physical organ in a certain animal species becomes 
useless for a great many generations on account of the 
changed conditions of that species, the organ will entirely 
disappear. There is a deep and rapid stream in Mam- 
moth Cave, Kentucky, that contains a great many fish. 
The light of day never enters the cave, and for that reason 
the fish never have an opportunity to see, even if they 
had eyes. Nature is ever conservative, and therefore 
never creates and maintains organs that are not needed. 
For this reason the fish of the cave are " stone blind." 
When man, in the infancy of the human race, was an 
arboreal animal or "cave dweller," he had muscles in his 
ears like those of a horse, so that he could turn his ear in 
any direction and gather and intensify the rustling sound 
of a leaf and be warned of approaching danger. In civil- 
ized life he is not exposed to such dangers, and therefore 
has no use for such muscles, and they have almost ceased 
to exist. Nature never makes any half hinges, because 
they would be useless. She never maintains organs that 
serve no purpose in the natural economy, and therefore 
all the organs of physical beings must be used or they will 
perish. 

That style of exercise that is used solely for the promo- 



26 EXERCISE. 

tion of health, is called "calisthenics," and may consist of 
exercising with Indian clubs or dumb-bells, or going 
through the extensive routine of an ordinary gymnasium 
every day, or of walking or running. There is one very 
important principle that should govern every one in the 
matter of taking exercise, and that is this : The condition 
of the mind when exercising must always be considered. 
If the character of the exercise is distasteful to a person, 
there are two reasons why it will fail to be of much if any 
benefit to him. In the first place, he will probably abandon 
it before it amounts to anything. In the second place, the 
dissatisfied state of his mind is liable to do him more harm, 
especially if he is sick, than the exercise would do good. 
All exercise should either be pleasant in itself or carry with 
it some ultimate object or hope that is pleasant to contem- 
plate. If a person feels that some good or pecuniary gain 
will be accomplished aside from the promotion of health, 
the exercise naturally becomes pleasant and satisfying to 
the mind, and in that way favors digestion and does much 
good. It is a notable fact that persons who suffer from 
dyspepsia, lung disease, and other depressing affections, 
are in a subnormal state so far as vitality is concerned and 
very little inclined to exercise at all. It is best for such 
patients to place themselves under conditions that compel 
them to exercise in the open air. If they have a long 
walk to and from their place of business, it is all the better 
for them. Walking calls into use almost all the muscles 
of the body, more or less, and in that way is capable of 
much good. 



EFFECTS OF THE MIND UPON THE BODY. 2 J 



EFFECTS OF THE MIND UPON THE BODY. 

The influences of the mind upon the body manifest 
themselves in a multiplicity of ways. When a person with 
a usually sunny and pleasant face takes on a corrugated 
brow, with wrinkles about the eyes, and has a "far away" 
or vacant look, such phenomena are to be hailed as the 
outward expression of a deeply seated grief, anxiety, or 
dissatisfied state of mind. In such cases there is a con- 
stant mental effort to overcome the trouble, whether 
domestic or otherwise, and this gives rise, in many cases, 
to a state of mental abstraction that renders the individual 
somewhat oblivious to his surroundings. An unhappy 
state of the mind or an unduly anxious condition cannot 
exist for a considerable length of time without seriously 
affecting the general health. 

When a person is suffering from pain or infirmities that 
are wholly physical, a haggard and wrinkled appearance of 
the face may exist, but that total abstraction that shows 
the mind to be struggling with intricate and distressing 
questions is absent. All these things have to be con- 
sidered in dealing with disease and also in our efforts to 
prevent it. 

This may be assumed as a principle that is immutable : 
A reciprocal relation between the mind and body always 
exists ; that is, the condition of the body always affects the 
mind, and the condition of the mind always affects the 
body. Trouble is a mental affliction, and sooner or later 
develops a physical one. The gravity of the physical 
derangement is very liable to be in direct proportion to 
the extent and severity of the mental perturbation. Busi- 



28 EFFECTS OF THE MIND UPON THE BODY. 

ness difficulties and embarrassments are health-destroying, 
nerve-exhausting, peace-disturbing, and sleep-preventing 
afflictions that are familiar to almost every business man 
who has passed the meridian of life. They are also dis- 
tressingly familiar to the physician in general practice, as 
he is usually confronted with the business complications 
of others, as well as his own. The friction with customers, 
the constant attention and mental strain that business life 
requires in order to succeed, are all wearing and depress- 
ing upon the nervous system, and yet are of minor im- 
portance compared with the distressing anxiety that arises 
from inability to meet financial obligations. 

Following all these, and closely related to them, comes 
the grim and terrible nightmare of the closing century — 
a dread of financial failure and bankruptcy. 

Happily for us all, nature has provided the human 
family with a redundance of nerve energy, so as to afford 
a supply for ordinary contingencies ; but under long and 
severe mental strains, the supply gives out and nervous 
prostration follows: In such cases the nerve forces are 
inadequate to properly stimulate any of the organs of the 
body, digestion is greatly impaired, the blood is impover- 
ished, color fades from the cheeks, and the general trend 
of the patient is to a lower state of vitality, because the 
blood, diminished in quantity and defective in quality, 
cannot nourish and properly excite the brain and nervous 
system. This further illustrates the correlation between 
the mind and body. 

In cases as above outlined, the sphere of medicine is 
very limited, as the primary and principal trouble is men- 
tal, and an effort to restore the patient to health and 
vigor without removing the exciting cause of diseased 



EFFECTS OF THE MIND UPON THE BODY, 29 

conditions is like giving pills and powders in order to get 
rid of a thorn in the flesh. 

There are two principal sources of mental affliction that 
concern mankind, and the physical derangements they 
entail are as widely different as the origin of the mental 
disorders. One is business trouble, and develops that 
wide range of diseases known as dyspeptic and nervous. 
The other is the sorrow of all sorrows and trouble of all 
troubles, — domestic discords and wrangles that finally 
separate husband and wife, — and also disappointment in 
love affairs. 

In the mental afflictions incident to business complica- 
tions and overwork, the expenditure of nerve force is 
greater than the daily income, and physical bankruptcy 
must necessarily follow sooner or later. But the rapidity 
with which business men recover from financial disaster 
and regain their physical and mental equilibrium, is 
wonderful. Dear as money is to us all, the cases are rare 
in which men fail to recover from the state of nervous 
exhaustion that bankruptcy usually brings. 

But the tenderest and most sacred chords that ever thrill 
the human heart are those of love and affection between 
husband and wife or between lovers. When these are 
permanently severed, a feeling of heartrending disappoint- 
ment and mortal anguish from which there is no recovery 
often takes possession of the mind. 

Any influences that permanently reduce the flesh and 
vitality of a person have an intrinsic tendency to establish 
in that person a liability to disease, especially to consump- 
tion. When a young lady in whom there is but little, if 
any, predisposition to consumption, is disappointed in her 
affections to the extent of being heartbroken, the color 



30 EFFECTS OF THE MIND UPON THE BODY. 

usually fades from her cheeks, she loses flesh, her diges- 
tion suffers, and in a few months she is liable to pass into 
a state of decline, — ■ another name for consumption ; and 
when she has passed away her friends truthfully say : " She 
died of a broken heart." 

Almost every one is familiar with such cases. Unfortu- 
nately the millions of eyes that are steeped in tears wrung 
out by the pangs of blighted hopes in love matters, are 
not limited to the state of celibacy, as many young people 
of both sexes are ruined by following the heroes and 
heroines of plays and love stories, and in that way led to 
indulge hopes with reference to married life that can never 
be realized. When a young lady who has lived an ideal 
life and pictured in her morbid imagination an ideal hus- 
band and an ideal home, is confronted with the cares and 
privations of a poor man's home, to which are usually 
added the responsibilities and anxieties of motherhood, the 
realities of her young life seem so strangely unreal and 
disappointing to her that she is heartbroken. In this way 
the seeds of disappointment are sown, and domestic inhar- 
mony and grief with all their painful complications are 
the fruits. 



GENERAL DISEASES. 



?>*< 



DYSPEPSIA. 

Other names : Indigestion ; atonic dyspepsia ; heart- 
burn ; pyrosis. 

As the digestive organs are really the blood factory of 
the human body, from which the entire organism is nour- 
ished, from which the system is repleted and sustained 
during the multiplicity of diseases to which humanity is 
liable, it has been thought proper to deal with this disease 
extensively in the opening chapter of the book, as there is 
scarcely a disease of any gravity, acute or chronic, in which 
the digestive functions are not more or less impaired. 

Dyspepsia is known by several names as follows : Indi- 
gestion, heartburn, pyrosis. The term employed by physi- 
cians, is atonic dyspepsia, the word " atonic " meaning 
debility, as almost all cases of chronic indigestion are due 
to a debilitated state of the nervous system. 

Symptoms. — Appetite irregular or lost, digestion painful 
and difficult, a heavy, disagreeable feeling in the stomach 
after meals, sour stomach from the decomposition of food, 
heartburn, flatulence, and sometimes vomiting of partially 
digested food, frequent belching of burning fluid, usually 
called "waterbrash," the tongue broad and flat and gener- 
ally pale. The bowels are constipated as a general thing. 
There is drowsiness after meals, and sometimes patients 
have great difficulty in keeping awake, while at night they 

31 



32 DYSPEPSIA. 

are afflicted with wakefulness, usually called " insomnia." 
The memory is often defective, there is more or less head- 
ache, and in many cases that distressing complication 
known as "sick headache." This is very common with 
dyspeptics, the attacks often occurring every week, while 
in others every two weeks or at wider intervals. The 
regularity with which these paroxysms occur is hard to 
account for, as they are seldom if ever due to malarial 
influences. Many cases have been known to the author 
in which sick headache occurred on a certain day of every 
week without an exception for several years. 

There are several varieties of dyspepsia. First, we 
have the nervous dyspepsia that affects business men of 
the nervous-sanguine temperament. 

Such men eat rapidly, do not properly masticate their 
food, and use too much liquid to wash it down. Second, we 
have the flatulent dyspepsia afflicting hysterical women, and 
attended with great accumulation of gas in the intestines. 

The third variety is acid dyspepsia, and is caused by 
eating coarse, greasy food. The fourth is called irritative 
dyspepsia, and is characterized by sickness of the stomach, 
and more or less vomiting, the tongue being small and red. 

Termination. — With reasonable care in reference to 
diet and other habits of living, including the avoidance 
of stimulants, the worst forms of dyspepsia are curable. 

Treatment. — One of the most important things in con- 
nection with the treatment is to use such articles of food 
as the patient, by long experience, has found best adapted 
to his particular case, so far as easy and painless digestion, 
regularity of the bowels, and maintenance of a vigorous, 
healthy body are concerned. It is best to be regular in 
eating both as regards time and quantity of food taken. 



DYSPEPSIA. 33 

Many dyspeptics have irregular appetites. Sometimes 
they have scarcely any, and therefore eat but little. This 
condition may continue for several meals, during which the 
system becomes run down, and finally calls loudly for 
nourishment, the appetite being morbidly increased. The 
patient is then liable to eat enough at one time for three 
or four meals. As he cannot digest that much, he is 
seized with colic pains of the stomach and bowels, severe 
sickness of the stomach, and other disorders associated 
with acute indigestion, the condition lasting for several 
days. It is obvious from the foregoing that the life of 
the chronic dyspeptic is a series of ups and downs due in 
a great measure to irregularity in eating. Hence, the 
following general advice is given to all dyspeptics : — 

First, use the kind of food that is nourishing and most 
easily digested. 

Second, take plenty of time for chewing, and use but 
little fluid with meals. 

Third, for reasons to be hereafter mentioned at length, 
avoid the use of stimulants. Use a due amount of exer- 
cise, and for this reason it may be advantageous to live 
some distance from your place of business, so as to com- 
pel a regular amount of walking every day. 

Fourth, all exercise for the purposes of health should 
either be pleasant in itself or have associated with it some 
ultimate purpose that is pleasant to contemplate. 

At the close of the treatment of this disease a single 
drug will be given, which, conjoined with good hygienic 
measures, will cure almost all cases of dyspepsia. But 
before entering upon the drug treatment it is desirable 
that all readers, and especially all dyspeptics, have a cor- 
rect understanding of the unfavorable manner in which 



34 DYSPEPSIA. 

stimulants of all kinds, including tea and coffee, affect the 
organs of digestion. 

Under the influence of an excitant, the brain and nerves 
work harder, the stomach secretes more juices, digestion is 
more complete, the liver secretes more bile, the pancreas 
more pancreatic .juice, the kidneys more urine, the peris- 
taltic or worm-like action of the bowels is increased, the 
heart beats faster, the lungs fill and empty themselves 
quicker, the state of general vitality is higher, and the 
individual actually lives faster and wears out quicker 
than he otherwise would ; but the most unhappy effect of 
a general stimulant is, that after its action ceases every 
organ of the body drops down to a sluggish or subnormal 
state and waits to be aroused by another stimulant. 

There is scarcely anything more obvious to the intelli- 
gent reader than this : That any drug having the power, 
when taken in moderate quantity for a limited time, to 
favorably stimulate digestion, also has the power to ruin the 
digestive functions when taken in large quantities, or dur- 
ing a long period of time in less quantities. A knowledge 
of these facts caused the author twenty-five years ago to 
put a close watch upon coffee as a leading factor in caus- 
ing dyspepsia and its great train of associated diseases. 

The manner in which coffee enfeebles digestion and 
develops those obstinate dyspeptic conditions, such as sick 
headache, painful colics, constipation of bowels, hypo- 
chondria, insomnia, and many other maladies, seems as 
clear as a cloudless noonday, and it is hoped will be equally 
clear to the reader. The eternal principle that should 
govern and limit the use of all stimulants is this : A cor- 
responding period of depression always follows the exhil- 
arating effect of a stimulant. 



DYSPEPSIA. 35 

If a strong cup of coffee is taken at breakfast, a feeling 
of moderate and rather pleasant excitement lasts almost 
until the next meal. For this reason dyspeptics who 
limit their coffee drinking to the morning meal have but 
little trouble, comparatively, in digesting their breakfast, 
because the nervous system that presides over the diges- 
tive functions is under a constant spur for hours. By 
noon, however, the stimulant has died out and a state of 
depression, in which the nervous energy drops as far below 
the natural as the coffee raised it above, is established. 

Before taking the coffee the patient is in a normal con- 
dition. For hours after taking it, he is in a supernormal or 
unnaturally excited state, and by dinner time, when the stim- 
ulant has given out, he is in a subnormal or depressed state. 

From the foregoing it seems evident that any stimulant 
that forces the digestive system to the exercise of undue 
energies in order to digest the morning meal, impairs the 
power of the stomach and bowels to digest the subsequent 
meals of the day. Unfortunately for mankind, coffee 
drinkers do not limit themselves to one or two cups at 
breakfast, but drink it at the other meals as well. Let us 
see what results from the constant use of a nervous stimu- 
lant of any kind. The muscular system, when forced to 
work too hard or too long, gets tired and, sooner or later, 
becomes exhausted. The same is true — exactly the 
same — of the nervous system, and a stimulant like coffee 
bears about the same relation to the nerves that the lash 
of the taskmaster of the South did to the muscles of the 
slaves in the cotton fields, and therefore, if coffee is taken 
three times a day, or even once a day in large quantities, 
a state of partial nervous exhaustion is almost sure to follow, 
and with it one of the worst forms of dyspepsia imaginable. 



36 DYSPEPSIA. 

In such cases the disease is called " atonic dyspepsia," 
as atony means debility, and is due to debility or more or 
less exhaustion of the nervous system. 

A better term for this form of dyspepsia would be " coffee 
dyspepsia," as it is essentially different in many respects 
from dyspepsia due to other causes, one of its most distress- 
ing characteristics being the frequent and terrible headaches 
that often accompany it, especially the "sick headache." 

Almost all coffee drinkers suffer from headaches more 
or less, and usually the trouble is moderate or severe ac- 
cording to the amount of coffee taken. 

The drug treatment of dyspepsia is exceedingly simple, 
consisting of a single remedy, and is probably worth more 
in curative results than any or all other drugs that have 
ever been given in this disease. If the proper hygienic 
measures are followed as heretofore advised, the extract 
of ignatia, given before each meal in doses ranging from 
one-half to a full grain, according to the size of the 
patient, will cure almost every case of dyspepsia. 

The remedy is to be given in pill form, and if the 
patient weighs from one hundred to one hundred and 
sixty pounds, a half-grain pill before each meal will be 
sufficient. Those weighing from one hundred and sixty 
to two hundred will take three-quarters of a grain, and 
all persons weighing over two hundred are to have a full 
grain. In all cases a pill is to be taken before each meal. 

The length of time necessary to give the drug depends 
mainly upon the length of time the disease has existed. 
In the worst cases it is better to continue it for many 
months without a solitary break. No remedy can have a 
fair trial in any disease unless it is given regularly and for 
a sufficient length of time. One of the pills must be given 



CONSTIPATION. 37 

before each meal, and should be continued a month for 
every year the dyspeptic condition has existed. Even in 
bad and very chronic cases, they may begin to afford relief 
within two weeks. One great difficulty in the treatment 
with this drug is that patients often feel so well by the 
end of the first month that they think they are cured, and 
either drop the medicine or forget many times to take it. 
This is very wrong, as it should be taken for months after 
the patient is seemingly well. The principle upon which 
the remedy acts is this : During the time it is given it 
stimulates the nerves that preside over the functions of 
digestion, rendering the digestive process practically per- 
fect, and rilling the veins and arteries with an abundance 
of good, red, healthy blood. This blood nourishes and 
stimulates the brain and nervous system, which, in turn, 
properly stimulate the organs of digestion, rendering the 
further use of medicine unnecessary. 

CONSTIPATION. 

Other terms for same : intestinal torpor, costiveness. 

This is a disease or habit of the system in which there 
is general inactivity of the bowels, either due to nervous 
debility of the muscular structure, causing diminished 
worm-like action, or to a deficiency of the secretions of 
the liver and bowels. It is marked by a change in the 
appearance, frequency, and quantity of the stools. 

Causes. — Dyspepsia, irregular habits of the patient, im- 
proper food, organic diseases of the stomach and liver, 
and lead poisoning. 

Symptoms. — When a person has one stool per day, he 
is supposed to be in a normal condition, so far as action of 



38 CONSTIPATION. 

the bowels is concerned, but is not necessarily in an abnor- 
mal state if more or less than that number occur. 

Some cases of constipation are so moderate as to cause, 
but little inconvenience ; others are somewhat distressing, 
in which the bowels move only once in two or three days, 
with stools dry and lumpy; while others in which the bowels 
move only once or twice per week are attended with great 
straining and distress, the face being flushed, and the blood 
vessels about the head and face filled to a point threatening 
apoplexy. 

There are other cases in which the stools are frequent, 
but small and hard, and act as an irritant to the intestinal 
tract, especially to the rectum. In such cases there is 
generally more or less mucus attending each movement of 
the bowels. When constipation sets in, there is a gradual 
change in the character of the stools, followed by dyspep- 
sia, more or less headache, mental derangement or stupor, 
dizziness, fluttering of the heart, and often great distention 
of the abdomen. 

Termination. — Never fatal. 

Treatment. — The successful treatment depends upon a 
change of diet, regular habits, and hearty cooperation of 
the patient. 

Every person who can possibly have one operation of 
the bowels per day should have a regular hour for going 
to stool and should not allow business engagements nor 
anything else to interfere with his habits in this respect. 

This is a disease in which physic should never be given, 
and yet every one so afflicted is disposed to take it and 
thinks it is impossible to do without it. This is emphati- 
cally true with reference to constipation : The physicking 
treatment never cures a single case, nor will a drug treat- 



CONSTIPATION. 39 

ment of any kind, except when conjoined with hygienic 
measures, ever succeed. It must be remembered that all 
cases of constipation, except the hereditary form, are asso- 
ciated with atonic dyspepsia, both gastric and intestinal, 
the atony, or nervous debility, which is the same thing, 
being due in most cases to the excessive use of tea or 
coffee, alcohol or other stimulants, or to exhaustion of the 
nervous forces in dealing with the annoying affairs of life, 
whatever they may be. All these things must be con- 
sidered in formulating a rational treatment for constipa- 
tion. As the underlying cause of the disease, aside from 
heredity, is dyspepsia, the treatment is practically the same 
as that given for dyspepsia, as far as drugs are concerned. 
Therefore, to overcome the atony, or nervous debility, 
give the solid extract of ignatia in pill form before each 
meal, the dose ranging from one-half to a full grain ac- 
cording to the size of the patient. Adults weighing from 
one hundred to one hundred and sixty pounds are to take 
one-half grain pills, those weighing from a hundred and 
sixty to two hundred, three-quarters of a grain, and all per- 
sons weighing over two hundred are to take a full grain. 
The remedy must always be taken before meals and in no 
case more than one pill taken at a time. The treatment 
should be continued without any interruption for eight 
weeks, even in ordinary cases. In the most obstinate 
and distressing cases, it should be followed without a break 
for four months. This is all the drug treatment that is 
worth a trial in such cases, as the author has used the igna- 
tia treatment for nearly thirty years, and has found it so 
uniformly favorable in dyspepsia that he considers it as 
justly entitled to be ranked as a specific in that disease 
as quinine is in ague. 



40 CONSTIPATION. 

The great difficulty experienced in dealing with obstinate 
physical derangements is that the treatment is not suffi- 
ciently radical, and therefore the use of fruits as they are 
usually taken to overcome constipation is like trying to 
drive a railroad spike with a tack hammer, as not enough 
fruit is taken to do any good. There are but few, if any, 
persons who follow the fruit-diet plan with any regularity, 
taking but little, if any, between meals and using it at the 
table just as it happens to suit their taste. In order to be 
successful, the meat diet should be abandoned, to a great 
extent, and the fruit diet substituted. An abundance of 
fruit should be taken every day, the green fruits being 
most desired when obtainable. Of these the best of all 
are apples. Three or four apples every day can be eaten 
with advantage between meals. In addition to this, they 
should be eaten either fried, stewed, or baked at two meals 
during the day. Peaches, plums, and other fruits, except- 
ing blackberries, raspberries, and other fruits with small 
seeds, are beneficial in all cases. There is one important 
thing for all patients to remember, and that is this : The 
improvement from the fruit diet will not be observed 
immediately, nor will a seemingly favorable impression on 
any chronic disease that manifests itself suddenly be either 
lasting or beneficial. 

Recovery from any chronic ailments must be slow, as 
the human organism cannot be lifted at once out of the 
old ruts in which it has long been travelling. If, however, 
the fruits are eaten lavishly as recommended, to the ex- 
clusion, mainly, of meats, improvement will be observed 
within a week, and if continued, a regular and easy move- 
ment of the bowels will be the result, sooner or later. 
Fruits are said to be nature's cathartic, and it seems to be 



ACUTE DIARRHCEA. 4 1 

really so ; for the acid of the fruit in promoting movement 
of the bowels is not irritating and not in the nature of a 
physic, for anything acting naturally upon the bowels is 
not a physic. For this reason and this alone, perhaps, 
after regularity of the bowels has been established by the 
use of fruits, it does not become necessary to increase the 
quantity, but, on the other hand, a less quantity may 
suffice. 

ACUTE DIARRHCEA. 

This is a disease characterized by frequent and loose move- 
ments of the bowels, with or without pain, due to functional 
irregularity of the small intestines or to organic disease. 

Diarrhoea is caused by any irritating agents that enter 
the intestinal tract, or by indigestible food, or by food of 
any kind that fails to undergo the proper changes by the 
digestive process. Impure water, or food that is ill 
adapted to the purposes of nutrition and carries with it a 
large amount of inert matter, acts as a physic and keeps 
up a diarrhoea. 

A severe mental shock or an unduly excited condition 
of the mind, from any cause, or grief, or great anxiety, is 
liable to precipitate an attack of diarrhoea by arresting 
digestion. In such cases the food acts as a physic by pass- 
ing through the bowels almost unchanged. 

There are two forms of this disease, — acute and chronic. 

Symptoms. — Acute diarrhoea varies in accordance with 
the causes that produce it. When a patient within a few 
hours after meals is seized with pain and more or less 
flatulence, and has an anxious desire to go to stool, it is 
safe to presume that at that particular time he ate some- 
thing that did not agree with him. The food failed to 



42 ACUTE DIARRHCEA. 

agree with him because, for some reason, it was not digested. 
The prostrating effects of hot weather with the great amount 
of water usually taken, have a great tendency to arrest 
digestion and bring on acute attacks of diarrhoea. As 
almost all acute forms of this disease are due to a common 
cause, indigestion, one general treatment is applicable to 
all, however numerous the names by which the different 
forms are designated. As the presence of undigested food 
along and through the entire canal is calculated to keep 
the bowels in a constant state of irritation, and in that way 
keep up an exhaustive discharge of water and mucus, the 
indications for a successful treatment are very clear, and 
are as follows : Rid the entire intestinal tract of all irritat- 
ing matter whatever and at the same time exercise a cura- 
tive and healing influence upon the irritated mucous 
lining of the bowels. The following is the proper remedy 
in such cases, because it always succeeds : For adults, give 
eight powders of five grains each of the first decimal 
trituration of mercurius dulcis, giving one powder every 
hour. They must not be given in water, as that dissolves 
the sugar and destroys the effect of the trituration. The 
powder may be mixed with a little common sugar and 
placed upon the tongue in a dry condition. Then give a 
tablespoonful of water. A patient should not take more 
than one tablespoonful of water every half hour when suf- 
fering from this disease. This amount should be care- 
fully measured, for it is just as important to measure and 
limit the water as it is to weigh or measure the medicine 
given. By the time the powders are all given, if not be- 
fore, they will commence to work off. The stools will 
gradually become darker until they are almost black, then 
they will fade in color at each movement until they are 



CHOLERA INFANTUM. 43 

natural. Then the trouble is over, provided the patient 
does not foolishly drink too much water. It is rarely 
necessary, after these powders are given in this way, to 
give anything to check the bowels, and never necessary if 
the directions are carefully followed regarding the use of 
water. If, however, it should even become necessary, a 
teaspoonful of paregoric two or three times per day for 
two or three days will answer. 

CHOLERA INFANTUM. 

SUMMER COMPLAINT. 

This is an acute inflammation of the mucous lining of 
the stomach and bowels with irritation of the nervous 
system, due in most cases to the heat of summer and 
teething. It is attended with very severe pains, vomiting, 
purging, intense thirst, and great prostration, sometimes 
resulting fatally during the first day or night of the attack. 

Causes. — Infancy, bad management, teething, excessive 
heat, improper or too much food, and the greatest of all, 
too much water. 

Symptoms. — The attack is usually very sudden and may 
occur in a child of perfect health or one suffering from a 
bowel disease. 

It begins with vomiting, is soon followed by severe 
purging, attended with intense pain and straining, the 
child having a determined disposition to stay on the 
vessel. The thirst is intense and is foolishly indulged by 
the mother or attendant to the great aggravation of the 
trouble, as the water, even in small quantities, excites both 
vomiting and purging, and is often the cause, and perhaps 
the main cause, of a fatal termination. 



44 CHOLERA INFANTUM. 

The thirst is one of the most prominent symptoms, and 
vain attempts are made by the mother to allay it by the 
use of ice or small quantities of ice water. The water is 
generally rejected as soon as it reaches the stomach, except 
perhaps small portions which pass into the bowels to 
aggravate the purging, and in this way frequent and pro- 
fuse evacuations are kept up until the blood is relieved of 
its watery elements ; while the child, often within a few 
hours, is in a wrinkled, shrunken condition as if from old 
age. In such cases there is a rapid tendency to a fatal 
termination. The irritable and restless condition gradually 
subsides, to be followed by one of stupor in which there is 
clammy coldness, with pupil of the eye contracted, when the 
child is almost hopeless, death occurring from exhaustion. 

Termination. — As cholera infantum is usually treated, but 
little care being observed regarding the use of water, the 
disease is very grave, and the result is at best doubtful ; 
but under proper drug treatment in which, practically, no 
water is allowed, the vomiting and purging can be arrested, 
and every child, if taken in hand immediately after the 
attack, ought to be saved. 

Treatment. — The first thing to be done is to stop as 
quickly as possible the sickness and vomiting, both of 
which are very prostrating. 

If the following directions are carefully followed, this can 
be easily and promptly done and the child restored to com- 
parative health within twenty-four hours. The great mis- 
take of mothers and doctors in dealing with this disease 
consists in the reckless use of water or some other form of 
fluid to control the thirst. Water, cold tea, coffee, milk, or 
any other form of fluid whatever is simply death to a 
child in this condition as commonly given. 



CHOLERA INFANTUM. 45 

The physician properly understanding the terrible effects 
of water in such cases has a constant trouble to keep the 
mother or attendant from killing the patient by giving ten 
times as much fluid as should be given, as it is a thousand 
times better to give none at all than too much. The doctor 
who has a loose and careless way in dealing with sick people, 
will lose half his patients in cholera infantum by failing to 
give proper emphasis to the dangers arising from the use of 
fluids. If he simply tells the mother to give a teaspoonful 
of water occasionally, he will find on returning in a few hours, 
if he inquires into the case, that she has been guessing at 
the amount of water instead of measuring it, and has given 
a half-dozen teaspoonfuls instead of one, and " occasion- 
ally " has been construed to mean this : to give the child 
water whenever it asks for it. Such management gets 
twenty times as much water into the child's stomach as it 
ought to have, and simply kills it. No such indefinite 
terms as "occasionally" should ever be used in medicine, 
and no mother or nurse should have charge of an infant 
with this disease who does not measure every drop of 
water and limit the amount to a teaspoonful every half 
hour. The drug treatment is as follows : To a child from 
one to two years old, give mercurius dulcis, the first deci- 
mal trituration, in four-grain doses, one powder being 
given every hour until six are taken. Each powder is 
to be placed upon a very little white sugar in the bottom 
of a teaspoon and then covered with a little more and put 
in the child's mouth in a dry condition. The medicine is 
tasteless, the sugar is pleasant and does not excite sick- 
ness. One teaspoonful of water is sufficient to wash it 
down, and if there is no water in the stomach at the 
time the powder is given, the child cannot throw it up, 



46 CHOLERA INFANTUM. 

as it would require more than a teaspoonful of water to 
bring the powder back. There may be, and often is, an 
attempt at vomiting, but owing to the total absence of 
fluid in the stomach it is impossible to reject the medicine. 
It soon commences to act favorably upon the mucous tissue 
of the stomach and to allay the irritation, so by the time 
the second powder is given the sickness is entirely gone. 
As the medicine is given every hour and with each dose 
a teaspoonful of water, there is only one teaspoonful to be 
given between the times of giving the medicine. These 
powders are strewn along and through the entire intestinal 
canal, exercising the effect of a local and healing balm to 
every part that they touch. Within six hours the medicine 
begins to work off, the stools become darker and darker 
until they are almost black, then gradually fading off into 
brown and, finally, into yellow or natural. While the 
powders are working off, the child will be somewhat more 
distressed, and there will be considerable straining at each 
movement, the pain and straining gradually ceasing as the 
stools change in color from black or dark green to natural. 
Another important turn is this : As the favorable change 
in the color of the stools proceeds, the movements become 
much less frequent and, finally, instead of occurring every 
fifteen minutes, occur once in four or five hours, and the 
child is, practically, well. To guard against the possibility 
of relapse, great care must be observed in reference to 
food and water, especially the latter. 

One of the happiest things in connection with the treat- 
ment is this : After the powders begin to work off and the 
stools become gradually less frequent, the thirst almost 
wholly subsides, and hence, irrational as it may seem, the 
quickest and best way to overcome the thirst is to give, 



INTESTINAL INDIGESTION. 47 

practically, no liquids. When the management of a case 
is conducted in this way, it is rarely necessary to give any 
other drug to restrain the action of the bowels. As the 
trouble is usually associated with teething there is a ten- 
dency to looseness of the bowels, and it is best for such 
children to have four or five evacuations in twenty-four 
hours. If, however, the bowels should be too loose and 
the stools inclined to green, it is obvious that digestion is 
imperfect and a pill of the solid extract of ignatia, one- 
eighth of a grain each, should be given at morning, noon, 
and at night. The best way to give such pills, and they 
are very small and coated with sugar, is to cover each pill 
with some kind of fruit or jelly and wash it down quickly 
with water before the patient chews it and gets the bitter 
taste. It is best for the child to take the pills in this way 
for two or three weeks, or until it is in a healthy, natural 
condition. There must be no carelessness in the use of 
these pills, for, while there is no danger in giving one 
three times a day, there would be serious trouble if a 
double dose were given at any time. 

One-eighth of a grain is intended for a child fifteen 
months old. If younger, one-sixteenth will be large 
enough. 

INTESTINAL INDIGESTION. 

INTESTINAL DYSPEPSIA. 

This disease is a derangement in the functions of in- 
testinal digestion in which there is usually considerable 
decomposition of food that has failed to digest, due to 
defects in the pancreatic, biliary, or intestinal secretions, 
or from deficient worm-like action of the intestines. A 



48 INTESTINAL INDIGESTION. 

defect in the secretions of either one of these organs, 
namely, pancreas, liver, or intestines, is sufficient to cause 
distressing intestinal dyspepsia, and yet the cases are rare 
in which the defect in secretions is not more or less in all 
three of these organs. The disease is characterized by ab- 
dominal pain, distention of the bowels, coming on several 
hours after meals, with nervous disturbance and more or 
less emaciation. 

Causes. — Bad diet, rapid and irregular or over eating, de- 
ficient exercise, overwork mentally, the immoderate use of 
stimulants, including tea, coffee, and tobacco. It may also 
be due to organic disease affecting the intestinal tract, 
liver, or pancreas. It is frequently hereditary. 

Symptoms. — The disease may be either acute or 
chronic, usually chronic. The acute variety is generally 
the result of an irritant in the small intestines, pain is 
rapidly developed, great flatulence, sometimes severe 
cramp attending the pain, slight feverishness, coated 
tongue, appetite morbid or lost, pains in the limbs, and 
often a mild attack of diarrhoea. 

If the attack develops rapidly, there is usually a paroxysm 
of colic, caused by distention of the bowels with gases. 

Severe attacks are most frequently caused by derange- 
ment of the liver, the stools are light colored, often slight 
jaundice and high-colored urine. 

Chronic Variety. — This form is generally caused by 
decomposition of partly altered food from the stomach. 
It is attended with pain more or less severe in character, 
coming on from two to four hours after meals. There is 
often tenderness and fulness in the right side and also in 
the umbilical region. There is considerable gaseous disten- 
tion of the abdomen, and shortness of breath is often expe- 



INTESTINAL INDIGESTION. 49 

rienced from pressure of the inflated bowels and stomach 
against the diaphragm. There is great disturbance of the 
nervous system due to a limited and impoverished condition 
of the blood from impairment of the digestive functions. 
Spirits are depressed, with sleeplessness, or imperfect 
sleep attended with disturbing dreams, headache, dizziness, 
deficient mental application, palpitation of the heart, 
numbness of the extremities, and sometimes pains through- 
out the body. 

Termination. — Favorable under proper and timely 
treatment. 

Treatment. — In the acute variety the pain is often so 
severe as to require a remedy for immediate relief. In 
such cases it is best to give a one-fourth grain morphine 
pill every two hours until perfect relief is secured. After 
relief is obtained, an effort should be made to arouse the 
liver and intestinal secretions. This is best done by giving 
five grains mercurius dulcis, the first decimal trituration, 
every hour until six powders are given. The remedy 
must not be given in water, but is to be placed on the 
tongue dry and washed down with a tablespoonful of 
water. The six powders thus given are calculated to act 
on the bowels, but under the restraining effect of the 
morphine may fail to do so, and may require a dose of 
castor oil or sweet oil, preferably the latter. This treat- 
ment will stimulate the liver and intestinal tract, and the 
stools will be changed from a light color to a dark brown. 
In almost all cases of this disease there is an atonic condi- 
tion or debilitated state of the nervous system. For this 
reason the nerves fail to properly excite the pancreas, liver, 
and muscular action of the bowels. This enfeebled condi- 
tion of the nerve forces is often caused by excessive mental 



50 INTESTINAL INDIGESTION. 

application or the burdens and perplexities of business. 
In addition to this the impoverished condition of the blood 
fails to properly nourish and stimulate the brain and 
nervous system. This increases the nervous debility and 
greatly adds to the trouble of intestinal dyspepsia. From 
the foregoing the indications for a rational treatment are 
very obvious and consist in stimulating, temporarily, the 
brain and nerve energies. When this is done they stimu- 
late the digestive organs and the latter digest the food 
and fill the veins and arteries with pure blood. This, 
however, may require weeks of time, when an abundance 
of good, healthy blood is created by the digestive forces, 
the brain and nerves are properly nourished and excited so 
as to render the use of an artificial stimulant unnecessary. 
Therefore the curative treatment consists in eating at 
regular hours, taking food that is easy to digest and 
properly adapted to the purposes of nutrition, never eat- 
ing too much at any one time, and conserving as far as 
possible the vital forces by avoiding the mental strain and 
labors that are the chief factors in causing both gastric 
and intestinal dyspepsia. 

The same drug is to be given in intestinal dyspepsia as 
that given in atonic dyspepsia of the stomach, therefore 
give the extract of ignatia amara in pill form, ranging in 
doses from one-half to a full grain, according to the size of 
the patient. One pill is to be given before each meal, and 
if the patient weighs from one hundred to one hundred 
and sixty pounds, a half-grain pill is the proper dose ; if 
from one sixty to two hundred, three-quarters of a grain 
is the proper sized pill. All persons weighing over two 
hundred are to take a full grain. The dose for children 
from eight years to twelve is one-quarter of a grain. Chil- 



ACUTE DYSENTERY. 5 1 

dren from two to eight that are subject to colic pains and 
other symptoms of disturbed digestion are to have one- 
eighth of a grain before each meal. Infants from three 
months old to two years one-sixteenth of a grain three 
times a day. In the chronic and obstinate form of intes- 
tinal indigestion, the drug should be given for at least ten 
weeks. In the treatment and management of intestinal 
dyspepsia, alcoholic stimulants, and also tea and coffee, 
except in a very moderate way, are to be avoided. 

ACUTE DYSENTERY. 

Other names : colitis ; ulcerative colitis ; bloody flux. 

This is an acute inflammation of the mucous membrane 
of the lower bowels, mainly the colon, followed sometimes 
by fever, terrible pain, almost constant desire to stool, dis- 
charges from the bowels being small and bloody. 

Causes. — The disease prevails most extensively in the 
summer and early autumn months. The depressing effect 
of hot weather is probably an exciting cause and, conjoined 
with this, may be included a reckless use of unripe fruits, 
and the use of impure drinking water, especially the 
latter. 

Symptoms. — The catarrhal and most common form of 
dysentery begins gradually with diarrhoea, more or less 
sickness of the stomach, increased temperature, and loss 
of appetite. These symptoms may continue for two or 
three days, when the real dysentery sets in, with pain on 
pressure along the transverse and descending colon, colicky 
pains in the navel region, burning pain in the rectum, and 
a feeling as if something offensive was there and a con- 
stant desire to go to stool. Stools gradually change from 



52 ACUTE DYSENTERY. 

a fecal character to that of mucus, pus, and blood, the 
latter largely predominating. In some cases there is ob- 
stinate vomiting. The stools vary in number from ten to 
thirty in twenty-four hours. The duration of the real 
dysentery, unless very successfully treated, is from a week 
to ten days, and leaves the patient greatly reduced in flesh 
and very weak. 

Termination. — Favorable, except in persons debilitated 
or suffering from other affections or intemperance. 

Treatment. — It is proper to regard dysentery under all 
circumstances as a grave disease, and in the late war, when 
it prevailed epidemically, it was said to be more destructive 
to life than all the weapons of warfare. In one regiment 
it seemed to affect, in one way or another, so many of the 
men that the colonel of the regiment offered a reward of 
ten dollars for a healthy stool. 

Dysenteric patients should be confined to the bed from 
the first, and the stools removed from the room as soon as 
passed. The vessels should be disinfected with a solution 
of carbolic acid of the strength of one tablespoonful to the 
pint. The diet should be of a kind most easily digested 
and void of irritating properties. 

As regards the drug treatment of this disease, the golden 
opportunity is during the premonitory or warning symp- 
toms. Whenever dysentery exists in a family, or even in 
a town or neighborhood, extensively, it is safest to regard 
all cases of diarrhoea as the first stage of dysentery and 
treat them accordingly. If this is done and a proper treat- 
ment adopted, every case can be broken up before the 
bloody discharges set in. Suppose, for example, that in a 
family of a dozen children there are three cases of dysen- 
tery. Each one of these cases has commenced with a 



ACUTE DYSENTERY. 53 

diarrhoea, lasting about three days before the beginning of 
the bloody flux. Should a diarrhoea attack another one of 
the children, there is every reason to believe that it will 
develop, as the other cases have, dysentery. 

The proper treatment, however, is employed to break 
up the diarrhoea, and in doing so the dysentery is com- 
pletely aborted, and so on with every other case that occurs 
in the family. Experiences of this kind have been so ex- 
tensive in the practice of the author that he feels warranted 
in giving the following as a specific treatment in dysentery, 
provided it is adopted before the bloody discharges set in : 
To every patient with the supposed dysenteric diarrhoea, 
give a five-grain powder of the first decimal trituration of 
mercurius dulcis every hour until six powders are given. 
The powder is to be placed in the mouth or on the tongue 
in a dry condition, and then washed down with a table- 
spoonful of water. The powder must never be dissolved 
nor given in water, as that destroys the effect of the 
trituration. In this stage of the disease there is some 
fever and liable to be considerable thirst, but water must 
not be given except in tablespoonful doses, once every 
half hour. 

As a tablespoonful of water is given every hour with a 
powder, there is only one tablespoonful to be given between 
powders. The medicine will work itself off in eight or ten 
hours, the stools becoming dark as soon as the physic com- 
mences to operate, and the color will deepen until they are 
almost black, and then gradually shade off into brown and 
finally yellow, or natural. As the stools change from black 
to the natural color, they become less frequent, the griping 
subsides, and the trouble is over. In all such cases as the 
above, if the patient limits the water drinking to one swal- 



54 ACUTE DYSENTERY. 

low at a time every hour for a day or two, the diarrhoea will 
not return and he will surely have no dysentery. 

If for any reason this abortive treatment should be neg- 
lected until the dysentery is fully established, it will not 
break it up, and we are compelled to do the best we can 
with a fully developed case of the disease. The treatment, 
however, as given above is the best way in which to rid the 
intestinal tract of all irritating matter, even after the flux 
has set in. When this is done the action of the bowels 
may be properly restrained by giving one-half grain of 
opium and one grain of acetate of lead every two or three 
hours, so as to limit the stools to ten or twelve in twenty- 
four hours. If the patient should be a child five years old, 
give Dover's powder instead of the opium, giving one grain 
of the Dover to a half grain of the acetate of lead. For 
adults, one grain of opium to two grains of acetate of lead 
is the proper dose in ordinary cases. 

To overcome the terrible burning and annoying desire 
to go to stool, laudanum and sweet oil may be injected into 
the rectum with a small, black rubber syringe, the quantity 
being for an adult, a teaspoonful of the laudanum to a table- 
spoonful of the oil. After it has been held from five to 
ten minutes the patient must discharge it into a vessel to 
avoid the constitutional effect of the laudanum. If, from 
the exhaustive evacuations and deranged nutrition, symp- 
toms of great debility supervene, brandy is indicated and 
may be given every half hour in teaspoonful doses, and 
even in larger quantities. But that which is most vitally 
important in dealing with dysentery, is to take it during 
its developing stage and treat it as outlined above and 
break it up, so as to avoid the pain, complications, and 
dangers that must always accompany the disease when 
once fully established. 



EPIDEMIC CHOLERA. 55 

EPIDEMIC CHOLERA. 

Other names : cholera ; Asiatic cholera ; spasmodic 
cholera ; malignant cholera. This is an acute, specific 
disease, both epidemic and infectious, and is attended with 
the most violent purging and the discharge of rice-water 
stools, constant vomiting, muscular spasm, or cramp, often 
followed by fatal collapse. 

Cause. — The cause of the disease is a bacillus, or spe- 
cific poison, or a life germ that is seen only by the micro- 
scope. It is supposed that the main power of infection is 
in the cholera stools, and that emanations from these stools 
poison the air and in that way extend the epidemic from 
one locality to another. One attack of it does not afford 
protection from the second. 

Symptoms. — It may set in abruptly, attacking a person 
previously in excellent health, or it may commence with 
premonitory symptoms, consisting of a severe diarrhoea, 
sickness of the stomach, griping pains, and more or less 
prostration. The first stage of cholera begins with a chilly 
feeling, great thirst, coated tongue, pain in the bowels, and 
several watery stools during the day, all these symptoms 
being attended with weakness. 

In the second stage the stools become very frequent, or 
immense in quantity, consisting of a whitish, rice-water 
fluid, there is terrible vomiting, the matter thrown from 
the stomach being mixed at first with bilious matter and 
finally becoming like rice water. As the water of the 
blood is being discharged rapidly from the body through 
vomiting and purging, the thirst is constantly increasing. 
Muscular cramps finally come on, affecting most of the 
muscles of the body, but especially severe in the legs. 



56 EPIDEMIC CHOLERA. 

In the third stage, the rapid stools, excessive vomiting, 
and spasm of the muscles continue, the eyes are sunken, 
the cheeks hollow, lips blue, the skin of the hands and 
fingers is wrinkled as in old age, the heat of the body 
rapidly fails, the pulse is small, the voice weak, and all the 
symptoms point to a fatal termination. Death sometimes 
occurs in three hours and is at other times delayed for two 
days, even in the fatal forms of the disease. 

In the stage of reaction the heat of the body gradually 
rises, the pulse gets stronger, the face takes on a more 
natural appearance, the stools are less painful and not so 
frequent, sickness of the stomach subsides, and the patient 
commences a slow recovery, or the case may drift into a 
condition of cholera typhoid from which recovery is slow. 

Termination. — This is very unfavorable, as the death- 
rate ranges from twenty-five to seventy-five per cent. 

Treatment. — In the treatment of this terrible disease 
there are two exceedingly important things to be done. 
The first is to take the case during the premonitory symp- 
toms, or those of diarrhoea, and treat it so as to prevent 
the occurrence of cholera, for in almost every case in 
which the diarrhoea is cured the cholera fails to develop. 
Experience has shown that it is bad policy merely to check 
this diarrhoea with opiates and astringents, as it only delays 
the trouble that must sooner or later come on, the diar- 
rhoea in such cases breaking out as soon as the opiate is 
withdrawn. It is therefore best to remove all irritating 
matter from the bowels by giving calomel in divided doses 
as follows for an adult : Mercurius dulcis, the first decimal 
trituration, thirty grains. Divide into five powders and 
give one powder every hour by placing it in a dry state 
upon the tongue and allowing it to be washed down with 



EPIDEMIC CHOLERA. 57 

a tablespoonful of water. It will act on every part of the 
intestinal tract, producing first an irritant effect, and 
second a healing and soothing effect. During its primary 
action the bowels are thoroughly emptied, the stools be- 
coming almost black and gradually fading into the natural 
color. When this is done it is rarely necessary to give 
any other remedy. During the whole treatment of the 
diarrhoea, water must be given in teaspoonful doses every 
half hour, as larger amounts tend to keep up the diarrhoea 
and endanger life by final development of cholera. The 
second important thing to be done is to commence a 
vigorous treatment with the first appearance of the dis- 
ease, and prevent the stage of collapse that is almost 
always fatal. A great many cholera mixtures are used 
in this stage, but the basis of all such mixtures is opium 
in some form, and upon this drug we must rely almost 
absolutely in order to control the terrible symptoms. 
Just after a severe vomiting, when the stomach is sup- 
posed to be empty, a full half grain of morphine should 
be given. If thrown up, another dose of equal size should 
be given, and so on until the drug is retained. Within a 
half hour the pain and spasm of the muscles may be 
slightly relieved, but if great relief is not apparent within 
forty-five minutes another half grain should be given, as 
there is scarcely any danger of fatal poisoning by mor- 
phine in half-grain doses in cholera. 

During all the time the morphine is being given, hot 
poultices should be applied to the abdomen to overcome 
the cramp. Morphine given in this way or by hypodermic 
injection is the sovereign remedy in cholera, just as it is in 
cholera morbus. There is scarcely anything that goes 
down the throat calculated to do as much harm as water 



58 CHOLERA MORBUS. 

in such affections of the stomach and bowels. Instead of 
water checking the thirst, it provokes it by causing both 
vomiting and purging. In this way a half pint of water 
given to allay the thirst is liable to cause a loss to the 
system of two or three times that amount by vomiting 
and liquid stools. This gives rise to greater thirst, and 
more water is given with the same results. It is all 
wrong, and the thirst may be controlled much quicker by 
limiting the amount to a teaspoonful every half hour. 

CHOLERA MORBUS. 

Other names : bilious cholera ; sporadic cholera ; Eng- 
lish cholera. 

This is an acute inflammation of the mucous membrane 
of the stomach and bowels attended with great pain in the 
abdomen, continual vomiting and purging, cramp colic, 
the cramp affecting the abdominal muscles and those of 
the extremities. The pulse is rapid and weak, the face 
anxious and covered with cold perspiration. 

Causes. — The most important of all causes are the irri- 
tating effects of hot weather. As the heat of summer 
is very depressing to the nervous system, the power to 
digest food is diminished while at the same time the copious 
draughts of cold water further reduce the digestive energy 
of the stomach, causing a fit of acute indigestion, and that 
is what cholera morbus practically is, acute or temporary 
indigestion. 

Symptoms. — The disease commences with but little if 
any warning and almost always in the latter part of the 
night. The first symptoms are those of deathly sickness, 
soon followed by vomiting and purging, accompanied with 



CHOLERA MORBUS. 59 

terrible griping pains. During the sickness and vomiting 
there are painful cramps of the abdominal muscles and 
those of the extremities. To commence with, the vomited 
matter is generally undigested food, showing, although it 
has been in the stomach for hours, that it has undergone 
but little change. The part of the undigested food that 
is not vomited passes into the bowels, arouses the secre- 
tions by acting as an irritant, and brings on a profuse 
liquid diarrhoea. The stools are usually a yellowish green. 
If the attack is unusually severe, approaching in gravity 
epidemic cholera, the stools will take on the " rice-water" 
character. The patient is rapidly reduced in strength and 
seemingly in flesh also, the features are shrunken and 
wrinkled, the surface cold and covered with perspiration, 
pulse frequent and feeble. The thirst is great and water 
excites vomiting. 

Termination. — This is very favorable under the right 
treatment if the patient is in a healthy condition at the 
time of the attack. In those suffering from the infirmities 
of old age the mortality is great. Drunkards, in this as 
in all other violent and prostrating diseases, are most liable 
to perish, as they are shorn of half their strength and 
power of endurance at the commencement of the attack. 

Treatment. — Happily there is a rational and almost 
unfailing remedy for this distressing disease. It is best 
not to give any medicine to restrain the action of the 
stomach in its efforts to get rid of the offending contents 
until it has pretty thoroughly emptied itself. If it were 
possible for the stomach to retain and absorb enough opium 
to stop the vomiting and leave the organ distended with 
undigested food, it would be very unfortunate if not dan- 
gerous. Therefore, the stomach must be emptied and 



60 CHOLERA MORBUS. 

a pint of warm water will be a material assistance in rid- 
ding it of all offending matter. The rest of the treatment 
is easy and simple and consists in giving from one-fourth 
to one-half grain of sulphate of morphine as follows : 
Give it in pill form so as to avoid the disagreeable taste, 
put the pill well back on the tongue and give a teaspoon- 
ful of water to wash it down. The point is this : In order 
to avoid having the pill thrown up, give as little water as 
possible, and if this amount can be limited to a teaspoonful 
to wash it down, it will not be sufficient to wash it up. 
If the stomach is entirely empty, the pill will be absorbed 
in one-tenth the time that it would be if it were full of 
food. After about three-eighths of a grain of morphine 
is given on an empty stomach, the sickness and pain will 
begin to subside in twenty minutes, and within three-quar- 
ters of an hour, if the dose has been sufficiently large, the 
patient will be perfectly relieved and will not likely need 
any more medicine of any kind. Morphine is the best 
of all remedies in these cases and should be given in a dose 
sufficiently large to render perfect relief in three-quarters 
of an hour. 

It is not always possible to tell how large a dose a par- 
ticular case will require, and it may be best to give a quar- 
ter of a grain and wait about forty minutes, and then if 
necessary give another quarter. It usually takes about 
a half grain to secure perfect relief. 



INTESTINAL COLIC. 6 1 



INTESTINAL COLIC. 

This disease is a spasmodic contraction of the muscular 
structure of the bowels, It is attended with acute parox- 
ysmal pain near the umbilical region, and is relieved by 
pressure or the application of heat. 

Causes. — Obstruction or constipation of the bowels, 
impaired digestion or the presence of indigestible food, 
collection of gases, an excessive amount of bile in the 
intestines, or lead poisoning. 

Symptoms. — There are frequent pains spreading over 
the abdomen, attended with intervals of more or less com- 
fort; the pain is often very severe and accompanied by 
cramps of the most excruciating character. The patient 
is restless, with an anxious, distressed countenance, and 
tries to relieve the pain by lying on his stomach. There 
are often nausea and vomiting and a desire to go to stool. 
The bow r els are usually bound but sometimes are loose. 

Termination. — Most favorable. It rarely terminates 
fatally. 

Treatment. — In all cases of severe pain the attention 
must be directed to immediate relief. For this purpose 
there is nothing better than a morphine pill, one-fourth 
grain, given every hour until the pain is relieved. After 
relief is obtained an effort must be made for a radical cure. 
For this purpose eight or ten powders, five grains each, of 
mercurius dulcis, the first decimal trituration, should be 
given, one powder being given every hour and followed 
by a physic of sweet oil, two tablespoonfuls. In this way 
the patient will get from four to five grains of calomel, 
which will act on the liver and intestinal tract. After it 
works off the stools will change from a very dark brown 



62 CATARRHAL ENTERITIS. 

or black, caused by the mercury, to a normal color, and the 
trouble will be over. 



CATARRHAL ENTERITIS. 

Other names : inflammation of the bowels ; intestinal 
catarrh ; acute diarrhoea. This is an inflammation of the 
mucous membrane of the smaller bowels, attended with 
pain, soreness on pressure, and diarrhoea. 

Symptoms. — It usually commences with a chill or chilly 
feeling, followed by a fever which is sometimes considera- 
ble. The pain that accompanies the fever is severe, but 
comes and goes. The pain is just below the stomach. 
There is more or less sickness, with occasional vomiting. 
The diarrhoea setting in soon after the attack is obstinate 
and severe. The stools are a greenish yellow, mixed with 
undigested food. 

The duration of the disease is from four or five days to 
two weeks. 

Termination. — Favorable if properly treated. 

Treatment. — The main thing in these cases is to keep 
the bowels as near a condition of absolute rest as possible. 
With this idea in view the diet should be restricted to 
chicken broth, milk, and articles of food that do not irri- 
tate inflamed bowels. 

Rest in bed is very important, as any movement of the 
body is painful to the patient and has a tendency to ag- 
gravate the inflammatory condition. Where the disease 
exists in children it is exceedingly troublesome to manage, 
the most difficult thing being to control the pain. The 
way to accomplish this deserves very careful consideration. 
As a rule children do not bear opiates well, and for this 



CATARRHAL ENTERITIS. 63 

reason they should be given as little as possible. But they 
cannot bear the pain and something very decided in its 
action must be given to relieve it. In the great majority 
of cases there are green stools, and these never exist either 
in children or adults except in connection with severe pain, 
and it is almost out of the question to control such pain 
until the stools are changed from green to natural. In 
this affection there is often vomiting, and this and the 
green stools call for the administration of mercury, but it 
must be given in very small doses to avoid the irritating 
effects of the physic. Calomel in doses of three-tenths 
of a grain may be given to children every hour, until five 
or six powders are given. They will act gently on the 
stomach and bowels, will change the stools from green to 
natural, after which the griping pains will cease. When- 
ever the stools are natural in color, the diarrhoea will sub- 
side and the little patient will pass into a quiet sleep that 
may last for hours. The best way to give the drug is as 
follows : Mercurius dulcis, the first decimal trituration, 
grains fifteen, divide into five powders and give one every 
hour until all are given. The poAvders must be placed in 
the mouth dry and washed down with a swallow of water. 
Children should not be allowed to drink over a teaspoonful 
of water every half hour until the diarrhoea is entirely con- 
trolled. After the powders have worked off, should it be 
necessary to give anything to control the pain and move- 
ment of the bowels, paregoric in doses ranging from three 
to six drops, according to the age of the child, may be 
given every three or four hours. 

Should the green stools and griping pains affect adult 
patients, the same treatment must be followed, doubling the 
quantity of the drug and giving it every hour whether 



64 DRUNKARD'S DYSPEPSIA. 

there is sickness of the stomach or not. Long experience 
has shown that the pain is a great deal easier controlled 
after the stools are changed from green to the natural 
color, and recovery is much more rapid and less subject to 
relapses. In all adult cases after the stools have become 
natural in color, opium, to keep the bowels in a state of 
perfect rest, should be given. One grain every three or 
four hours will be sufficient. 

Beef, mutton, or chicken broth may be given several 
times per day in small quantities, or milk with a limited 
amount of stale bread when desirable. As there is a 
tendency to diarrhoea, water should not be used except in 
teaspoonfuls every half hour. It is much better to use 
milk or something that is nourishing. 

DRUNKARD'S DYSPEPSIA. 

In this form of dyspepsia, to the baneful effects of a 
stimulant to the nervous system is added the terrible irri- 
tation of alcohol to the mucous membrane of the stomach. 
Like other stimulants, alcohol quickens the heart's action 
and arouses every organ of the body to undue activity, and 
except for the chemical effect of the drug upon the food in 
the stomach, has an intrinsic tendency to promote diges- 
tion by increasing, temporarily, the nervous forces. But 
unfortunately alcohol has been found in all cases of arti- 
ficial digestion in which tests have been made to retard 
the digestive process. If this were the only objection to 
the use of alcohol before or during meals, it would be 
enough to condemn it ; but the stimulating and irritating 
effect is a hundred times more deplorable than the local 
chemical effect upon the food. It will therefore be ob- 



DRUNKARD'S DYSPEPSIA. 65 

served that alcohol interferes with the functions of diges- 
tion in three different ways. First, by stimulating the 
entire organism. As a corresponding degree of depres- 
sion always follows the exhilarating effect of a stimulant, 
a state of the digestive functions that is more or less enfee- 
bled must always follow the effects of alcohol. Second, the 
irritating effect of the drug upon the stomach causes that 
organ to secrete for a limited time an abnormal amount of 
gastric juice. This, of course, favors digestion for a little 
while, but the stomach is unduly irritated and gradually 
drifts into a state of chronic inflammation in which the 
functions of digestion are seriously disturbed. Third, the 
chemical action of the alcohol upon the food renders it 
difficult to digest and almost doubles the time required for 
the completion of the digestive process. This, of course, 
draws heavily upon the nervous and vital forces, and has a 
tendency, sooner or later, to produce nervous exhaustion. 

Under the continuous use of alcohol the mucous mem- 
brane of the stomach, which is usually thickened, is in a 
chronic state of irritation, and in time the organ begins to 
reject food. The vomiting established in this way gradu- 
ally grows worse, until it has a serious effect upon nutri- 
tion. 

This impoverishes the blood, which fails to nourish and 
properly stimulate the brain and nerve fibres, and thus 
greatly increases the alcoholic indigestion. It may reach 
a stage, if the patient survives long enough, in which the 
mucous membrane of the stomach is to a great extent 
destroyed. However this may be, when an alcoholic dys- 
peptic gets so far on the downward road as habitually to 
throw up part of his food, his days are numbered, as ceas- 
ing the use of the poisonous drug will rarely save him. 



66 PERITYPHLITIS — APPENDICITIS. 

There is no available treatment of this disease except 
leaving off the stimulant before the habitual vomiting is 
established and resorting to the treatment given for atonic 
dyspepsia, which please see. All such cases, however, are 
exceedingly obstinate, and the organic changes render 
recovery under the best possible treatment doubtful. 

K 

PERITYPHLITIS — APPENDICITIS. 

Other names : perityphlitic abscess ; suppurative appen- 
dicitis. 

Perityphlitis is an acute inflammation, involving a small 
portion of the colon called the caecum, usually resulting in 
an abscess. Appendicitis is an acute or subacute inflam- 
mation of a little worm-like appendage of the bowel, called 
" appendix vermiformis." It usually leads to perforation of 
the appendix and the formation of an abscess. 

(Without a knowledge of anatomy the nature of these 
two affections is very hard to understand ; but so many 
deaths have occurred in the last few years from appendi- 
citis, and so many surgical operations have been performed 
and the diseased appendix removed in order to save life, 
that the public have become deeply interested in the sub- 
ject of appendicitis. It is therefore thought best to give 
a careful and plain description of the two diseases with 
which this chapter is headed, and which are anatomically 
connected with each other.) 

Perityphlitis is usually caused by appendicitis, but not 
always. Appendicitis is caused by the lodgment of a 
foreign body in the appendix. The small seeds of fruits 
may get switched off into this useless pocket of the bowels 
and cause inflammation, leading to perforation of the appen- 



PERITYPHLITIS — APPENDICITIS. 67 

dix by an abscess. It seems to be more common in males 
than in females, and is most frequent between childhood 
and the age of thirty. 

Symptoms. — The two diseases, perityphlitis and appen- 
dicitis, have symptoms very much alike. The symptoms 
of appendicitis commence with soreness on the right side 
of the abdomen, low down, and are attended with severe 
pain, sickness, and vomiting. The right leg is generally 
drawn up so as to relax the muscles of the right side and 
relieve the pressure upon the inflamed portion of the bowel. 
At the seat of the pain and soreness is found, sooner or 
later, a hard lump or swelling. The affection may com- 
mence with a chill. Whether it does or not there is fever 
from the beginning, and the pulse is full and strong as in 
other inflammations. 

The bowels are costive, tongue coated, and colic pains 
frequent and severe. The dangerous tendency of the 
disease is to the formation of an abscess, and during its 
development there are chilly feelings, with greatly in- 
creased temperature, throbbing of the tumor, and general 
increased gravity, all characteristic symptoms of the sup- 
purative process, or the formation of an abscess that is 
liable to lead to a fatal termination. 

Treatment. — An effort should be made to allay the 
inflammation as soon as possible. For this purpose it is 
best to give the tincture of veratrum veride in two-drop 
doses every hour, commencing as soon as the pulse reaches 
one hundred beats per minute. Continue the drug for six 
hours, then leave it off for two hours, and then give it six 
hours longer. In the mean time the swelling must be 
painted every five or six hours with a strong tincture of 
iodine. 



68 INTESTINAL PARASITES. 

(This is a disease that requires the attention of a skilful 
physician from the commencement, or as soon as it is 
recognized.) 

When it becomes evident that an abscess is forming, 
the suppurative process should be hastened by flaxseed 
poultices, and as soon as the matter is located by fluctua- 
tion of the tumor, it should be freely lanced. Morphine 
should be given to quiet the pain and keep the bowels in 
a state of rest. 



INTESTINAL PARASITES. 

TAPEWORMS. 

Causes. — The " armed tapeworm " is the most frequent 
in this country, the germ or embryo entering the bowels 
by the patients eating raw pork. 

The " unarmed " tapeworm enters the stomach by pa- 
tients eating raw beef infected with the tapeworm germs. 

Another "unarmed" tapeworm is the largest ever found 
in the human body, and the embryo is supposed to come 
from some kind of a fish. 

The egg of the worm is simply swallowed with food, 
hatches in the intestine, and grows to maturity. Why the 
worm Qgg is not destroyed by the gastric juices that eat 
up and dissolve all kinds of meat, hard-boiled eggs, and 
other solids, no one can tell. It is well to remember that 
but few people have perfect digestion, and when it is not 
perfect some of the food passes into the bowels undigested, 
and along with this food may pass unharmed the eggs from 
which various worms are hatched. Some parasites are 
exceedingly hard to kill, as worms seemingly as long and 



INTESTINAL PARASITES. 69 

large as a darning needle are found in the strongest cider 
vinegar, but of course are infinitely small and can be seen 
only with a microscope. 

The " unarmed" tapeworm is from ten to thirty feet 
long, has a round head and slender neck, somewhat like a 
snake. The most unfortunate thing connected with a 
tapeworm is that it is divided up into a multiplicity of 
joints, the longest worm having at least a thousand joints, 
each and every joint containing the sexual organs of both 
male and female. When a long worm gets broken into 
pieces, as frequently happens, the rapid propagation of 
new worms is readily imaginable. It is said that the 
ordinary tapeworm contains millions of eggs. The worm 
lives in the upper part of the small intestines, to the walls 
of which it secures itself by suckers. 

Symptoms. — In many cases where tapeworms have 
been found by accident to exist, their presence was at- 
tended by no symptoms whatever ; but as a general thing 
the symptoms are essentially those of dyspepsia, such as 
a painful hunger, severe colic in the stomach and bowels, 
loss of flesh, constipation, fluttering of the heart, and some- 
times itching about the anus and nose. 

As in dyspepsia, all the symptoms are usually relieved 
by the patient eating a full meal. There is no symptom 
nor group of symptoms to afford infallible evidence that a 
tapeworm exists in the bowels of any patient until a worm 
or part of a worm is passed. 

Treatment. — In dealing with this trouble it is proposed 
to give one remedy, and only one, for the destruction of all 
the varieties of tapeworm ; and the drug is a positive spe- 
cific, provided all the directions are carefully followed, and 
if they are not followed the chances are more than even 



70 INTESTINAL PARASITES. 

that the whole of the worm will not be expelled, and as 
each joint contains the reproductive organs of both sexes, 
any part of the worm remaining in the bowels will breed 
other worms. The idea that the expulsion of the head 
of the worm ends the trouble is exceedingly delusive, as 
the power of reproduction belongs to every part of the 
worm. 

The treatment and full directions are as follows : First 
go to a drug store and get one ounce of powdered Kousso. 
The drug should be as fresh as possible. Twenty-four 
hours before giving the medicine, a thorough physic must 
be taken, and this should be in the morning before break- 
fast and sufficient to thoroughly empty the bowels. But 
very little food should be taken during the day, so on the 
following morning the stomach and bowels will be practi- 
cally empty. Put a half ounce of the Kousso in a half 
pint of hot water, let it sit till it cools, then stir it well, 
have the patient swallow half of it, and in a half hour 
swallow the other half. This must be taken as soon as 
the patient arises from bed and no food eaten until the 
Kousso works off, which is usually within four or five 
hours. 

Should it not pass off in that time, a full dose of castor 
oil should be given. To avoid sickness from the use of 
this remedy it is sometimes found best to give a half cup 
of hot coffee after each portion of the drug. Given in 
this way it is rarely necessary to repeat the dose, but the 
author has found a few cases in which he was compelled 
to give the remedy in ounce doses, owing, most likely, to 
impurities of the drug or to its having been kept too 
long. 



INTESTINAL PARASITES. 7 1 



ROUNDWORMS, 

Of these there are two varieties : the long roundworms, 
ranging in length from eight to fifteen inches, are the most 
common ; the eggs of these worms are introduced with food 
or drink, and hatch and establish their dwelling-place in 
the small intestines, though they meander through the 
entire bowels, more or less. The other variety is com- 
monly called " pinworms " ; they are also called " seat- 
worms " and " threadworms." They develop in the lower 
and larger bowels, mainly the rectum. Their eggs or larvae 
gain entrance with food and drink. These little annoying 
things are from a quarter to a half inch in length, and look 
like a piece of white sewing thread. They conceal them- 
selves in the folds of the rectum or anus, and in wriggling 
about cause the greatest itching imaginable. 

Symptoms. — There are no symptoms that positively 
indicate the presence of the roundworms except the pas- 
sage of one or more from the bowels. Many symptoms 
are given in the medical books suggesting that worms exist 
in the bowels, but such symptoms are liable to occur in 
other affections, and therefore there is but little reliance 
upon any signs except the actual passage of worms. 

The symptoms of pinworms are intense itching and a 
frequent desire to go to stool. As anything that irritates 
the mucous membrane excites a flow of mucus, the frequent 
stools caused by pinworms consist mainly of such mucus. 
These small worms sometimes get into the sexual organs 
of children and cause terrible suffering. 

Treatment. — There is an infallible remedy for the long 
roundworm, and it is as follows : 

Santonine, grains ten, 



72 GASTRALGIA. 

Calomel, grains three, 

Mix and divide into five powders. 

Give one every three hours during the day, and at bed- 
time give a couple of teaspoonfuls of castor oil. 

If there is any difficulty in getting the child to take the 
castor oil some other gentle physic will answer. 

The same remedy may be given for pinworms, and in 
addition an injection of the following into the rectum may 
be given : Carbolic acid, one teaspoonful ; water, one pint. 
After shaking well, inject about one ounce into the rectum 
of a child, and have it sit on the vessel and pass it away 
immediately. This may be repeated every day for several 
days until the worms are all destroyed. 

In adults a half pint of the solution may be injected. 
After it is held four or five minutes, it must be passed into 
a vessel, and the rectum washed out with a half pint of 
pure water. In all cases, when pinworms cause great 
itching by their presence in the anus, an injection of cold 
water, to the amount of half a pint, should be given, and 
will almost always afford complete relief by dislodging 
them. 

GASTRALGIA. 

Other names : stomachic colic ; cardialgia ; gastro- 
dynia ; neuralgia of the stomach ; spasm of the stomach. 

This disease is commonly known as neuralgia of the 
stomach, and, as in neuralgia of other organs, the pain is 
intense, coming in paroxysms, and there is the severest and 
most painful cramp involving the muscles of the stomach, 
usually called " cramp colic." The pain is so terrible as to 
develop symptoms of fatal collapse, the countenance show- 
ing great anxiety and the face covered with cold perspiration. 



GASTRALGIA. 73 

Causes. — It may be due to a great many causes, but 
the most important are those influences that exercise an 
exhaustive effect upon the nervous system. Business 
troubles, family cares and anxieties, and indeed any and 
all things that use up nervous energy, favor the develop- 
ment of gastralgia, and with it acute indigestion. The 
disease may be caused by overeating or by the use of 
articles of food that are very hard to digest. 

Symptoms. — Almost all neuralgic affections are char- 
acterized by paroxysms, and this is especially true of 
neuralgia of the stomach. There is violent pain in the 
stomach, frequently severe cramp, the extremities are cold, 
stomach distended, patients often screaming from intense 
agony. These severe attacks may last only a few minutes 
at a time, but in some cases they may not subside for an 
hour or more. Even where no opiate is given, vomiting 
may occur, in which the stomach is entirely emptied of 
everything, including the gas that was the source of the 
most pain, and in that way immediate relief is obtained. 

Termination. — This is almost always favorable in refer- 
ence both to life and health. It is not a dangerous disease 
so far as life is concerned, but the treatment that is usually 
adopted by doctors, with a view of curing the affection, 
almost always fails, and persons in whom gastralgia is 
once fairly established seem to be doomed to suffer from 
it as long as they live. The author has always adopted 
in this extremely aggravating affection a treatment never 
given in any of the text-books, and that is essentially his 
own. He considers it strictly a neuralgic trouble, just as 
sciatica and other local disturbances are, and directs his 
treatment absolutely to the nervous system. So far as cure 
is concerned, nothing whatever can be accomplished during 



74 GASTRALGIA. 

the paroxysm. This must be controlled with an opiate, 
and nothing is better than morphine. A quarter-grain pill 
of the sulphate of morphine may be given every half hour 
until the spasm and pain are overcome. In a day or two, 
when the patient has in a measure recovered from the 
prostrating effects of the attack, the proper treatment 
should be commenced to prevent the recurrence of at- 
tacks. This is strictly the curative treatment. The par- 
oxysms are periodic, in some cases coming on every month, 
and in others occurring only two or three times per year. 
In cases that have existed for years, the treatment to be 
given hereafter should be followed for six months. It con- 
sists in giving the solid extract of ignatia three times per 
day, in doses as large as the patient will bear without caus- 
ing headache or twitching of the muscles. For persons 
weighing from one hundred to one hundred and fifty 
pounds, a half-grain pill will probably be strong enough. 
In those weighing from a hundred and fifty to two hun- 
dred pounds, a three-quarter-grain pill may be given before 
breakfast and before dinner, and a half-grain pill before 
supper, as a large dose of the drug taken at night is liable 
to interfere with sleeping. It must be remembered in all 
cases, however, if the size of the pill selected causes head- 
ache, a smaller one must be taken in its place ; for example : 
If headache occurs every day from the use of a three- 
quarter-grain pill before each meal, these pills must be 
discontinued and half-grain pills used instead. 

One of the very happy features of the treatment is 
this : The patient does not feel the effects of the drug 
at all, when the proper dose is given. The only effect 
that is observed is that the paroxysms cease to occur. 
Where the treatment is commenced immediately after one 



GASTRIC CANCER. 75 

paroxysm with a view of preventing the next one, which 
may be due in six weeks, it will almost always prevent it. 
The drug must not be left off for five or six months. 
After this, if no paroxysms have occurred, the patient is 
usually safe. Sometimes, however, after four or five 
years, the disease sets in again and must be treated in 
exactly the same manner. 

GASTRIC CANCER. 

Other names : gastric carcinoma ; cancer of the 
stomach. 

This is a malignant tumor or growth involving part of 
the stomach, with a tendency to constant development 
and gradual destruction of that organ. The functions of 
digestion are always interrupted more or less, giving rise 
to pain, vomiting, and other symptoms of acute dyspepsia, 
death sooner or later in all cases ending the suffering of 
the patient. 

Symptoms. — The first symptoms may be those of indi- 
gestion, gradually becoming more marked in character. 
In most cases there is vomiting soon after eating. In 
such cases the cancer is located at the upper part of the 
stomach, but if the vomiting should occur two or three 
hours after eating, it is at the lower part where the 
stomach connects with the bowels. The matter vomited 
may be imperfectly digested food or it may be food mixed 
with blood. Hemorrhage, which is very moderate in 
quantity, is liable to occur at any time, and the quantity 
being small, is not liable to excite vomiting for several 
hours, and therefore, when food is thrown up it is mixed 
with broken-up blood clots that look like coffee-grounds; 



76 ASCITES. 

hence the " coffee-ground " vomit is considered a char- 
acteristic symptom of cancer of the stomach. 

Termination. — This is always unfavorable. Medicine 
affords no hope whatever as far as recovery is concerned. 

Treatment. — This consists in doing whatever is possible 
to relieve the sufferings of the patient. A sour stomach 
may be controlled as well with the bicarbonate of soda 
(common baking soda) as with any other drug. Put a 
heaping teaspoonful in a half glass of water and let a 
swallow of it be taken as often as is necessary. The pain 
must be controlled, and for this purpose morphine may be 
given in one-fourth-grain doses, repeated as often as is 
needed. For convenience it is best to give the drug in 
pill form, as morphine pills in desirable doses are obtain- 
able at all drug stores. 

ASCITES. 

Other names : abdominal dropsy ; peritoneal dropsy. 

This is a collection of water in the abdominal cavity, 
causing great enlargement, usually stretching the skin 
covering the abdomen so as to give it a glossy appearance. 
The upward pressure is often so great as to seriously em- 
barrass respiration. 

Causes. — The disease may exist in connection with gen- 
eral dropsy or it may arise from obstruction in the liver, 
causing a delay in the backward flow of blood from the 
lower part of the body to the heart. Such a condition of 
the liver is almost always malignant and therefore incur- 
able, and so is the attending dropsy. The affection is also 
due to diseases of the heart and kidneys. 

Symptoms. — The dropsy comes on gradually. The first 



ASCITES. J? 

important and most noticeable symptom is the abdomi- 
nal enlargement, and this causes most of the other symp- 
toms by mechanical pressure. For example : Pressure of 
the fluid on the lower part of the colon causes constipation 
of the bowels, and pressure upon the vessels of the kid- 
neys causes the urine to be scanty, upward pressure against 
the diaphragm crowds the lungs and heart together and 
interferes with respiration and circulation. 

Termination. — This depends largely upon the cause of 
the dropsy, but when all the different causes are con- 
sidered, it is not very favorable. 

Treatment. — If the accumulation of water is great, 
threatening suffocation, the patient should be relieved 
immediately by tapping with a trochar. The operation is 
exceedingly simple and easy. It consists in making a 
little cut in the skin, an inch and a half below the navel, 
and then pushing the trochar, which is about two and a 
half inches long, into the cavity containing the water. 
The patient should be in a sitting posture, and the instru- 
ment should be pointed a little upwards and pushed as far 
as it will go, and then the trochar, which is the cutting 
part, is drawn out of the tube, or canula, the latter being 
left in. The water, which is usually a straw color, will con- 
tinue to flow until several gallons are drawn off. As the 
canula is only about the size of a small goose-quill, it will 
take some little time for the water to run off. The habit 
of giving exhausting cathartics and producing copious 
watery stools to get rid of the dropsy, is very bad, as a 
person cannot survive very long who has to be relieved in 
this way. If the kidneys can be stimulated so as to do 
double or triple duty for a short time, the water can be 
carried off rapidly and the resort to tapping avoided ; but 



yS CHRONIC GASTRIC CATARRH. 

ordinary remedies to act on the kidneys have never seemed 
to do much good in such cases. There is one remedy, 
however, that the author has used a great many times with 
most happy results. The preparation is as peculiar as it 
is wonderful in its effects, and is as follows : Common nails, 
one pound ; cider vinegar, one quart. After twelve or fif- 
teen hours, pour the vinegar off of the nails that are yet 
undissolved, and give the patient a half tablespoonful of 
this vinegar, holding the iron in solution, and repeat the 
dose every three hours if it does not offend the stomach, 
which it does not usually do, but it must be given largely 
diluted. After a few hours it will commence acting on 
the kidneys, and will carry off the water in twenty-four 
hours so that the skin of the abdomen will hang in loose 
folds. There is nothing like this in such cases. Some 
cases are entirely cured in this way, while in others the 
remedy finally loses its effect, as all medicines do in 
chronic cases where they fail to cure in a reasonable 
time. 



CHRONIC GASTRIC CATARRH. 

Other names: chronic dyspepsia; drunkard's dyspep- 
sia ; chronic gastritis. 

This is a chronic inflammation of the mucous membrane 
of the stomach, attended with thickening of the coats and 
shrinking away of the glands that furnish the gastric 
juice. There is pain at the pit of the stomach, more or 
less loss of appetite, difficult digestion, and depression of 
spirits. 

Causes. — It is often caused by frequent attacks of acute 
gastritis, but much more frequently, perhaps, by the exces- 



CHRONIC GASTRIC CATARRH. 79 

sive use of intoxicating liquors. Tea and coffee may be 
used so recklessly as to cause the worst forms of dyspep- 
sia, and develop chronic gastritis. Irregular meals, indi- 
gestible food, or too much of any kind of food may lead, 
first, to indigestion, and second, to chronic inflammation 
of the membranes of the stomach, due to the scalding and 
irritating effects of sour food. Tobacco chewing is another 
frequent cause. 

Symptoms. — The symptoms of this affection are mainly 
those of a chronic and aggravated case of dyspepsia. As 
dyspepsia always accompanies chronic gastritis and chronic 
gastritis accompanies, to some extent, the worst forms of 
dyspepsia, the two diseases are very hard to separate. 
The disease under consideration is attended with loss of 
appetite at times, at others with a gnawing feeling of the 
stomach, or painful hunger, a feeling of oppression at the 
pit of the stomach, and also tenderness. There is liable 
to be swelling due to gases from decomposing food. 
There is usually more or less vomiting, especially after 
meals. Drunkards afflicted with this disease are very apt 
to vomit as soon as they rise from bed. Burning at the 
stomach, usually called " heartburn," is almost a constant 
symptom. There is almost always depression of spirits, 
with a drowsy, sleepy feeling during the day and an in- 
ability to sleep at night. These distressing symptoms are 
largely due to a deficiency in the digestive juices secreted 
by the stomach, or a defect in the quality of these juices, 
causing the food to sour instead of undergoing the natural 
changes from the digestive process. 

The sour and scalding fluid that is frequently belched 
up, sooner or later may cause inflammation of the throat, 
adding to the misery of the patient. 



80 CHRONIC GASTRIC CATARRH. 

Termination. — So far as life is concerned this is favor- 
able, but as regards complete recovery, it is not. 

Treatment. — The first thing to be done is to cure the 
accompanying dyspepsia if possible, and as soon as possi- 
ble, as the great acidity of the stomach, due to indigestion, 
acts as a constant irritant to every part of the mucous 
membrane. Meals should be taken regularly, the patient 
should be in a quiet, cheerful state of mind, if possible 
take plenty of time for meals, eat only those articles of 
food that are found by long experience best suited to his 
case, take no stimulants of any kind, but little sugar or 
starchy food, drink but little at meals, and eat no fat meat. 
To overcome the constipation that is one of the aggravat- 
ing features of this disease, it is best to resort to a fruit 
and vegetable diet, and eat but little if any meat, provided 
the fruit does not cause too much pain from an increase 
of the gases. The constipation cannot be improved, but 
can only be aggravated and made more distressing by the 
use of a physic of any kind. It dulls the sensibility of 
the intestinal canal, requiring the use of stronger and 
stronger irritants to arouse the muscular, worm-like action 
of the bowels. For this reason it is obvious that whatever 
is done in overcoming the constipation must be accom- 
plished through dieting, to the utter exclusion of physic. 
When a radical change is made in the diet, as when a 
patient is taken from a heavy meat diet and put almost 
exclusively upon fruits and vegetables, it may require some 
little time for the stomach to acquire a tolerance for the 
new diet, but after a number of days, provided a great 
deal of fruit is taken, the fruit acid will begin to act as 
nature's physic, the bowels will begin to move, the stools 
will become soft and easy instead of hard and knotty, the 



CHRONIC GASTRIC CATARRH. 8 1 

colic pains will gradually subside, and a greatly improved 
condition of the stomach can be hoped for. 

It seems there is nothing more rational, more sensible, 
than the substitution of a fruit diet, which should be un- 
irritating, for a drug treatment that is always distressingly 
so in the inflammatory conditions of the stomach and bow- 
els. In this affection we are dealing with inflammation of 
the mucous lining of the stomach. A physic is an irritant 
that arouses the secretion of the bowels, and at the same 
time increases their muscular action so as to empty the 
entire tract. This irritant cannot get into the bowels with- 
out passing through the poor, inflamed, and crippled stom- 
ach, and of course must cause great distress to that organ ; 
therefore, what can be more irrational than the use of 
physic in this complaint ? 

This is a disease in which the inflamed condition of the 
stomach tends constantly to increase the dyspeptic diffi- 
culty, while the dyspepsia is just as constantly aggravating 
the inflammatory affection. Therefore anything that will 
reduce the inflammation will act favorably upon the indi- 
gestion, or dyspepsia, and any remedy that will reduce 
the dyspepsia will favorably affect the inflammation. To 
save repetition the reader is referred to the treatment 
given for " acute gastric catarrh," in which the use and 
value of calomel in divided doses to heal and soothe the in- 
flamed membranes of the stomach are carefully explained. 

The use of ignatia in promoting digestion is also ex- 
plained in connection with that disease, and the whole 
treatment is applicable to the treatment of chronic gastric 
catarrh, the disease now under consideration. 



82 PROCTITIS. 

PROCTITIS. 

Other names : inflammation of the rectum ; rectitis ; 
catarrh of the rectum ; dysentery. 

This is a catarrhal inflammation of the mucous membrane 
of the rectum attended with pain, frequent stools, often of 
a mucous or bloody character and sometimes mixed with 
pus. The stools are often hard and lumpy. 

Causes. — The principal causes are constipation, the ha- 
bitual use of physic, hemorrhoids, and diseases of the liver ; 
but the most frequent cause is piles. 

Symptoms. — There is a burning or aching sensation in 
the rectum, with a desire to go to stool. When on the ves- 
sel or seat there is an inclination to bear down or strain, 
hoping in that way to be relieved from the distress. This 
sometimes causes falling of the mucous membrane of the 
rectum, but if it does not, it is liable to cause enlargement 
of the blood-vessels of the anus and bring on hemorrhoids, 
or what is the same thing, piles. The stools may be hard 
and lumpy or consist of a bloody mucus. There is gener- 
ally more or less sickness of the stomach, fever, and head- 
ache. In the most aggravated form of the disease there is 
great difficulty to pass water, especially in male patients. 
If the case be protracted, much of the tissue round the 
rectum is liable to become involved, developing an abscess 
and leading to fistula in ano, or fistula of the rectum. 

Termination. — The disease when uncomplicated is favor- 
able. 

Treatment. — The rectum should be thoroughly emptied 
with a pint injection of warm water. After this has passed, 
inject another pint and perhaps still another, until the rec- 
tum is thoroughly cleansed. The following suppository 



ACUTE GASTRIC CATARRH. 83 

will probably do a great deal of good in overcoming the in- 
flammatory condition by keeping the lower bowels in a state 
of perfect rest : — 

Opium, six grains, 

Sugar of lead, eighteen grains. 

Mix and divide into six powders. 
Put each powder into a large capsule and when ready to 
insert, cover it all over with vaseline and push it in with 
the point of the index finger, pushing it up into the rectum 
the whole length of the finger. One of these may be used 
in this way two or three times in twenty-four hours, but as 
soon as any of the lumpy, irritating stools come into the 
rectum they must be removed by warm water injections, 
after which the lead and opium capsule may be again inserted. 
The tormenting desire to go to stool may be relieved by 
injecting four ounces of cold water, that is, a half a table- 
glassful. This may be repeated a dozen times in twenty- 
four hours, as cold water often works wonders in reducing 
inflammation. 

ACUTE GASTRIC CATARRH. 

Other names : gastric fever ; acute indigestion ; suba- 
cute gastritis ; bilious fever. This is an acute inflammation 
of the lining membrane of the stomach, attended with 
fever, loss of appetite, sickness of the stomach, and more 
or less vomiting, pain, and difficult digestion. 

Causes. — The disease may be caused by defects in the 
juices of the stomach that digest the food ; for example, 
the gastric juice may be either deficient in quantity or de- 
fective in quality, or both. In addition to this, the food may 
be improperly masticated, owing to bad teeth, or eating too 
fast. Then, again, indigestible food may be eaten, the 



84 ACUTE GASTRIC CATARRH. 

stomach may be abused with hot drinks, and the worst of 
all, by intoxicating liquors. To sum it up, and get the 
causes into a condensed form, it is mainly due to indi- 
gestion. 

It is an affection that often arises from eruptive fevers, 
such as small-pox, measles, and scarlet fever. It is well to 
remember that the skin covering the outside of the body 
is closely analogous to the mucous membrane lining the 
inside, and any eruptive fever that breaks through and 
inflames the outer covering is very liable to break through 
and inflame the inner lining. 

Symptoms. — Loss of appetite, tongue heavily coated, a 
loathing for food, disagreeable taste in the mouth, con- 
stant sickness of the stomach, and occasional vomiting. 
The vomited matter is, to commence with, undigested food, 
but may finally be mucous and bilious matter. The inflam- 
matory fever attending this disease is mild, though thirst 
may be considerable. In most fevers there is a craving for 
acids, and that is especially the case in subacute gastritis. 
There are frequent sour eructations attended with pain, 
tenderness, and heaviness at the pit of the stomach. The 
bowels are usually loose. There is, many times, a great 
deal of nervous derangement, anxiety, and melancholy. As 
the affection is largely due to acute indigestion, it is obvi- 
ous that errors in diet must surely aggravate it. 

Termination. — This is almost always favorable but re- 
covery is slow. 

Treatment. — As the stomach is not in a condition to 
digest food, diet should be almost absolutely withheld for 
twenty-four hours or more. The vomiting can be best 
allayed by the use of calomel in small doses as follows : 
Mercurius dulcis, the first decimal trituration, twenty-five 



ACUTE GASTRIC CATARRH. 85 

grains ; divide into five powders and give one every hour 
until all are given. 

This trituration must always be placed in the mouth in 
a dry state, and swallowed with a small quantity of water 
or some other suitable liquid. The manner in which the 
drug acts in overcoming inflammation of the mucous mem- 
brane, both of the stomach and bowels, is very interesting, 
and is as follows : If calomel is sprinkled upon an ulcer of 
the skin or mucous membrane it greatly stimulates the 
healing process, but should the surface involved be very 
extensive, the crude drug could not be applied to every 
part of it without the risk of salivation. In subacute 
gastritis the whole mucous lining of the stomach is usually 
involved, and it is desirable to bring the drug in contact 
with every part of it. The system will not tolerate enough 
of the crude drug to allow this to be done ; therefore it is 
mixed with nine parts of sugar of milk, so as to spread it 
over ten times as much surface. The advantages of the 
trituration over the crude drug are twofold : first, ten 
times more surface can be reached by the trituration than 
by an equal amount of calomel not diluted with the sugar ; 
second, in the highly irritable condition of the stomach 
that exists in gastritis, the calomel is too severe, and to 
have the happiest effect must be reduced in strength by 
mixing it with the sugar of milk. As a healing stimulant 
it has only one-tenth of the irritating properties of pure 
calomel, and therefore it stops the sickness of the stomach 
by healing and soothing the inflamed membrane, and soon 
subdues the inflammation. After it passes out of the stom- 
ach it stimulates the secretions of the whole intestinal tract, 
and, acting as a physic, removes all irritating matter, such 
as imperfectly digested food, and in that way further con- 



86 GASTRIC ULCER. 

tributes to relief of the stomach. After the sickness of 
the stomach and other acute symptoms have subsided, the 
following is by far the best remedy with which to stimu- 
late the digestive process : Extract of ignatia, from one- 
half to three-quarters of a grain, according to the size of 
the patient, three times a day before meals. 

It is always given in pill form, and if the patient only 
weighs from one hundred pounds to a hundred and seventy- 
five, a half-grain pill is sufficient, but if more than one 
hundred and seventy-five, three-quarters of a grain must 
be given. 

GASTRIC ULCER. 

Other names : perforating ulcer ; peptic ulcer ; chronic 
gastric ulcer. This is a solution of continuity affecting 
the mucous membrane and some of the other coats of the 
stomach. In plainer language, it is a hole in the mucous 
membrane and other coats, caused by ulceration. It is 
attended with pain and deranged digestion and sometimes 
vomiting of blood. 

Causes. — It is probably due to self -digestion of the 
stomach at the seat of the ulcer. 

Symptoms. — The symptoms of indigestion are very 
prominent in this affection. There is constant pain in the 
stomach, which is increased by taking food. Vomiting is 
almost a constant symptom and may be greatly aggravated 
by eating. As the ulcerative process sooner or later de- 
stroys a blood-vessel, vomiting of fresh blood in large 
quantities is liable to occur and is very characteristic of 
gastric ulcer. If it is not vomited for some time after the 
hemorrhage occurs, it will of course be dark instead of 
bright red. The ulcer is slow in forming, and it may be a 



ACUTE GASTRITIS. 87 

year before it is fully matured. Sometimes, however, it 
develops rapidly, perforates all the coats of the stomach, 
and ends in death by perforation and inflammation in a 
few weeks. 

Termination. — This is more or less unfavorable. Many 
cases die and many recover. 

Treatment. — The stomach should be kept in a state of 
absolute rest if possible. In order to do this, beef, chicken, 
or mutton broth may be given several times a day by the 
rectum, but if for any reason this cannot be done, a milk 
diet by the mouth may be necessary. A quart of milk, or 
even more, may be given in twenty-four hours, by giving 
only a few ounces at a time, as it will be better borne 
when given in this way. 

For hemorrhage that may occur any time, it is best to 
give fluid extract of ergot in teaspoonful doses every hour 
until it is arrested. 

In order to hasten the healing process in the ulcer, give 
subnitrate of bismuth in twenty-grain doses, three or four 
times per day. It may be mixed with a little sugar, placed 
in the mouth, and then washed down with a swallow of 
water. 

ACUTE GASTRITIS. 

Another name : toxic gastritis. 

This is an acute and severe inflammation affecting the 
entire stomach, including the mucous membranes and 
muscular coats, and is attended with violent pain, incessant 
vomiting, the vomited matter being usually bloody mucus. 
To these distressing symptoms are added those of a fatal 
collapse. 

Causes. — ft is due to swallowing corrosive poisons, such 



88 ACUTE GASTRITIS. 

as corrosive sublimate, carbolic acid, or any other drug 
that burns and inflames the stomach. 

Symptoms. — Soon after the poison is swallowed there 
is deathly sickness and constant vomiting. After the 
stomach is emptied of all food, portions of the mucous 
membrane that have been destroyed by the irritant are 
thrown up, and with them clots of blood, or bloody mucus. 
There is a great depression of spirits, weak pulse, and 
skin covered with a cold sweat, and yet there is a terrible 
heat at the pit of the stomach and a burning thirst that 
nothing will satisfy. There is frequently a burning pain 
in the mouth and throat, as well as the stomach, and terrible 
purging, all from swallowing the corrosive poison. 

Termination. — Recovery is very doubtful, death being 
due to a great shock upon the nervous system and chemi- 
cal destruction of the stomach. 

Treatment. — So far as the treatment is concerned in 
this affection, almost everything depends on the nature of 
the drug causing the mischief. 

If it be a strong acid of any kind, excepting carbolic 
acid, bicarbonate of soda (common baking soda) should be 
given immediately in water, using a heaping teaspoonful 
to a half a glass of water and giving a swallow every 
minute until the gas ceases to rise from the stomach. As 
long as the gas rises the soda, however strong it may be, 
will not injure the stomach, as it is in a chemical fight with 
the acid. Should the poisonous drug be an alkali such as 
caustic potash, caustic soda or lye, used in washing, the 
best remedy is vinegar, and should be given diluted in 
water as long as gas rises from the stomach. 

Poisoning from drinking a solution of concentrated lye, 
or lye of any kind, is an accident that very frequently 



FEVERS. 89 

occurs among young children, who are disposed to drink 
everything they can get hold of. The treatment in all 
such cases is vinegar, given as above directed, and fol- 
lowed, after the gas ceases to rise, by a tablespoonful 
of sweet oil. Should lye be swallowed by a child and 
no vinegar at hand, a couple of tablespoonfuls of sweet 
oil should be given immediately, which will unite with the 
lye, forming a crude, imperfect soap. Melted butter or 
lard, or grease of any kind, can be used in the place of the 
oil and will have the same effect on the lye. After the 
action of the poison is destroyed in one of the above ways, 
the stomach may be left in an inflamed and irritable con- 
dition with constant tendency to vomit. In such cases 
solid food will not be borne by the stomach, and the diet 
should be milk, gruel, or animal broths. If carbolic acid 
should be swallowed, an alkali, such as baking soda, will 
do no good, as the drug is not really an acid. Oil is the 
best antidote for carbolic acid, and one or two tablespoon- 
fuls of sweet oil should be given immediately. Melted 
butter or lard will also answer, but if much of the terrible 
poison is swallowed the nervous system will be over- 
whelmed by the shock, and death cannot be long delayed. 
See chapter on poisons. 

FEVERS. 

Fever is a condition characterized by a rise in tempera- 
ture of the body, the heart's action being quickened, tongue 
usually dry or less moist than normal, and a general de- 
ranged condition of the secretions. 

The one symptom that belongs to all fevers and without 
which there can be no fever, is a rise in temperature above 



90 FEVERS. 

the natural, which is said to be ninety-eight and a half de- 
grees F. It is impossible for any one to determine, accu- 
rately, the degree of fever that a patient has, without using 
a thermometer. When the temperature is only about one 
degree above the natural, it is proper to say that such 
patients are a little feverish. If the temperature rises to 
a hundred and one, or a hundred and two, the patient is 
said to have " slight fever " ; if a hundred and three to a 
hundred and four, high fever, and when it reaches a hun- 
dred and five, a burning fever. There are but few con- 
ditions, either in inflammatory or common fevers, in which 
the temperature rises above one hundred and six. 

The height of the fever as witnessed by the thermometer, 
the experienced touch of the physician, nurse, or mother, 
affords some information regarding the severity of the 
attack and always deserves proper consideration ; but in 
the sick brashes and gastric disturbances of children, the 
intense fever that accompanies them is not necessarily a 
dangerous symptom, as the organism of childhood is in a 
vigorous, active, and keenly sensitive state, and responds 
so readily and violently to disorders of digestion and other 
minor ailments as to create unnecessary alarm. For ex- 
ample : A child after eating a very hearty supper may go 
to sleep apparently in a state of perfect health, and before 
morning may awake with a burning fever and intense 
thirst, and seem to be suffering from some terribly danger- 
ous disease. Sooner or later vomiting occurs, and perhaps 
purging also, the offending matter in the form of undigested 
food is gotten rid of, and by morning the child is compara- 
tively well. Such cases are constantly coming under the 
observation of practicing physicians. 



GENERAL MANAGEMENT OF FEVERS. QI 

GENERAL MANAGEMENT OF FEVERS. 

Before considering special fevers, it is thought best to 
give some plain and important facts regarding the general 
management of fevers. The most distressing feature of 
all fevers is the high temperature of the body, as its ten- 
dency is to dry up the secretions of every organ. This 
leads to constipation of the bowels, derangement of the 
liver and pancreas, and, consequently, to a diminished 
power to digest the food. The system, as if aware of this 
condition, does not call for food, and naturally enough there 
is no appetite. The urine is scanty and high colored, for 
the same reason that all the other secretions are limited in 
quantity, and in almost all cases of high fever attended 
with delirium, the latter is mainly due to a retention of the 
salts of the urine in the blood, known as uremic poisoning. 

From the foregoing, the obvious indications in dealing 
with fevers of all kinds are to reduce the temperature and 
hold it as near the degree of natural heat as possible. The 
manner in which this is to be effected depends greatly 
upon the character of the fever, whether due to malaria, 
the typhus, or typhoid germs, the specific poison of erup- 
tive fevers, or inflammation, the latter being called inflam- 
matory fever. In the great majority of general fevers it is 
impossible to reduce the temperature, to any material extent, 
by any drug treatment. In other words, the remedies given 
in the treatment of fever, except in the inflammatory type, 
affect the temperature but little, if any. This suggests 
other remedies besides drugs, in reducing the burning tem- 
perature of typhoid and other fevers that dry up all the 
secretions and tend to a fatal termination. Just in propor- 
tion as the fever can be lowered, all the secretions can be 



92 GENERAL MANAGEMENT OF FEVERS. 

conserved. For example : Should there be six degrees 
of extra temperature, the organic secretions would be con- 
sumed twice as fast, and the tendency to a fatal termina- 
tion twice as great as would be the case if the extra heat 
were but three degrees. Therefore every degree of fever 
that can be dispensed with, saves materially the natural 
secretions and the vitality of the patient. 

One of the eternal principles of nature is this : That the 
evaporation of water reduces temperature by absorbing the 
heat. Therefore if water is spread over the surface of any 
body, animate or inanimate, the temperature of that body 
is immediately lowered. If the body should be a physical 
one, that is, a human being, and such being should have a 
high fever, would not the evaporation upon the surface 
of the body have a direct tendency to lower the fever? 
It certainly would. This leads us up to a consideration of 
the power and efficacy of water in the treatment of fevers 
generally. 

There are five ways in which water can be used to great 
advantage in lowering the temperature : — 

First, Bathing in a bath-tub. 

Second, By using the wet pack, consisting of a dripping 
wet sheet or towels. 

Third, The shower, or spray bath. 

Fourth, The sponge bath. 

Fifth, By drinking large and frequent draughts of cold 
water. 

The use of the bath-tub, even where such a convenience 
is obtainable, is limited. The patients are frequently too 
weak to be bathed in this way, and even if not very weak, 
they are liable to become so by too long and too frequent 
ablutions. In the early stages of severe fevers, while the 



INTERMITTENT FEVER. 93 

patients are yet comparatively strong, the bath-tub can be 
used to great advantage when followed by the proper use 
of the spray or wet sponge. Where proper facilities are 
provided for taking care of the extra water and saving the 
bed clothing from getting wet, the spray bath, such as is 
used by ladies in watering house-plants, may be used several 
times a day with the happiest results. As all fevers are 
attended with evening exacerbations, that is, an increase of 
temperature of one or two degrees in the evening, this is 
the proper time for the water treatment, in whatever form 
is best suitable to the case. If used at all, it is best to use 
it freely during the three or four hours of the day in which 
the fever is highest. 



INTERMITTENT FEVER. 

Other names : ague ; chills and fever ; swamp fever ; 
malarial fever. 

This is a paroxysmal fever consisting of three stages, 
namely, a cold, a hot, and a sweating stage. The sweat- 
ing stage is followed by a complete intermission, varying 
in length according to the character of the attack. Until 
this is established by the recurrence of another chill, it is 
impossible to tell whether the type is quotidian, in which 
the chill occurs every day, the tertian, in which it occurs 
every other day, or the quartan, in which it occurs on the 
first and fourth days. 

Causes. — Malarial bacillus. These malarial-fever germs 
are true parasites, but how their effects manifest themselves 
periodically, and that, too, with such wonderful regularity, 
it is impossible to tell. There may possibly be several 



94 INTERMITTENT FEVER, 

species of the parasites, each one capable of developing 
a special type of the disease, as tertian, quartan, etc. 

Varieties. — There are many distinct types of this dis- 
ease. First, the quotidian, with a paroxysm every day; 
second, the tertian, with one every other day ; third, the 
quartan, with a paroxysm on the first and fourth days; 
fourth, octan, when the paroxysm occurs weekly ; fifth, 
the double quotidian, in which two paroxysms occur daily; 
sixth, the double tertian, with two paroxysms every second 
day. The dumb ague is an irregular form of the disease 
in which one of the stages, either hot, cold, or sweating, is 
absent. This is usually the cold stage. Sometimes two 
stages are absent, the sweating stage alone showing itself. 

Symptoms. — Each paroxysm has three stages, the cold, 
hot, and sweating. 

The cold stage begins with premonitory symptoms such 
as headache, yawning, sickness of the stomach, followed 
by a chill. The teeth rattle, the nails and lips become 
blue, the skin pale and rough like goose flesh, while there 
is great thirst and internal fever. The thermometer dur- 
ing a severe chill often ranges from one hundred and two 
to one hundred and four F. The duration of a chill is 
from fifteen minutes to an hour. 

The patient gradually passes out of the cold stage into 
the hot by the shivering ceasing, the surface becoming 
first warm, and then hot and flushed, the temperature 
sometimes reaching a hundred and six or even more. 
The pulse is full and strong, there is headache with 
nausea and great thirst, the skin being perfectly dry and 
swollen. The urine is always scanty and high colored, 
and the hot stage lasts from one to eight hours or more, 
according to the length and severity of the cold stage. 



INTERMITTENT FEVER. 95 

For example : if the cold stage is long and severe, the 
hot stage will be correspondingly so. 

The sweating stage comes on gradually, its first appear- 
ance being on the face and forehead, and then spreading 
over the entire body. The temperature rapidly returns to 
the normal standard, the patient is restored to a condition 
of comfort, and drops into a refreshing sleep. The dura- 
tion of the sweating stage is from one to four or five hours. 
From the time the sweating stage ceases until the chill of 
the next paroxysm begins, is called the intermission. 
During this time, the patient is seemingly in a state of 
usual health. 

Termination. — Almost always favorable. 

Treatment. — The treatment consists, first, in the use of 
remedies during the premonitory, or warning, symptoms of 
the chill, either to postpone or modify it. This may be 
effected by giving a full dose of morphine as soon as the 
warning symptoms appear. Just in proportion as the cold 
stage is modified as regards duration and severity, the hot 
and sweating stages will be. During the hot stage, cool 
drinks and frequent sponging with cold water will afford 
the greatest comfort. The sweating stage seldom, if ever, 
requires any treatment. 

All efforts to break up this disease and restore the 
patient to a condition of perfect health should be com- 
menced immediately after the cessation of the sweating 
stage, or, in other words, during the intermission. As 
before remarked, until the second chill occurs, the type 
of the disease cannot be determined, and, therefore, the 
length of time in which to give quinine or other remedies, 
to prevent another chill, is entirely unknown. For this 
reason the time is precious. The best remedy in the 



96 INTERMITTENT FEVER. 

acute form of the disease is sulphate of quinine, which 
may be given in three-grain doses every three hours until 
fifteen grains are given. If the next day the dreaded 
chill fails to occur, it is reasonably fair to presume that 
the quinine has prevented it, but at least twelve or fifteen 
grains of the drug must be given on the second day to 
guard against the tertian form of the disease. If by the 
third or fourth day there is no chill, it is evident that the 
attack is broken up. The quinine, however, should be 
continued in three-grain doses three times per day for 
about a week. Regarding the amount of quinine neces- 
sary to give in order to break up and permanently subdue 
an attack of ague, almost everything depends upon the 
amount of malaria affecting the district in which the 
patient lives. If this is slight, as shown by the limited 
number of cases, the amount of quinine necessary to 
break up and permanently cure an attack of ague is 
correspondingly small. In such cases nine grains of 
quinine per day will arrest the disease in three or four 
days, and by giving about six grains per day for four or 
five days longer, the chills will not return. 

Unhappily, if a case of ague is trifled with by giving too 
little medicine until it is allowed to return several times, 
the disease becomes chronic and obstinate, the skin more 
or less yellow, and, sooner or later, the patient has an 
enlarged spleen. Under such poor management patients 
gradually drift into conditions that are incurable by ordi- 
nary means, and start out on a health-hunting journey, but 
the ague stubbornly continues, regardless of the usual 
remedies. In such cases, whether the patient abandons 
the malarial district or not, the following prescription will 
effect a permanent cure : — 



REMITTENT FEVER. 97 

Sulphate of quinine, one drachm, 
Arsenious acid, one grain, 
Sulphate of strychnine, one grain, 
Aromatic sulphuric acid, ten drops, 
Extract of gentian, a sufficient quantity. 
Mix and divide into twenty pills. 
For an adult, give one pill before each meal. The cases 
are exceedingly rare in which this prescription fails to 
cure, however chronic and obstinate they may be. No 
one except an accomplished druggist should ever be 
trusted to put up this prescription. 

REMITTENT FEVER. 

Other names : typho-malarial fever ; bilious fever ; 
bilious remittent; marsh fever. This is a paroxysmal 
fever that may come on exactly like ague, that is, by a 
chill followed by a hot and a sweating stage, but usually 
the chill is not so long and pronounced as in ague, and the 
sweating stage is sometimes absent. 

It is characterized by an exacerbation or aggravation 
every day, usually in the evening, after which there is a 
remission or falling of the fever, generally in the latter 
part of the night and forenoon, and it is during these re- 
missions that patients must get their sleep. During the 
intense hot stage, there is severe headache and irritability 
of the stomach. In many cases there are sharp pains in 
the chest like pleurisy, always occurring, if at all, during 
the hot stage. 

Cause. — The presence in the blood of a parasite or 
malarial bacillus. 

Symptoms. — There is a moderate chill to commence 



98 REMITTENT FEVER. 

with, the temperature rising one or two degrees above the 
normal, tongue dry and coated, the coating usually of a 
lightish brown color, oppression at the pit of the stomach, 
headache, and pains more or less over the entire body, but 
mainly about the chest. 

Hot stage. — During this stage there is often vomiting, 
the coating of the tongue heavier and somewhat darker 
than in the cold stage, pulse full and often rising to a 
hundred and twenty, injected eyes, flushed face, severe 
headache, pains over the body, hurried respiration, and a 
temperature ranging from a hundred and four to a hun- 
dred and six. The bowels are usually costive, stools dark, 
urine scanty and high colored, the skin frequently yellowish. 
During the highest part of the fever there is often delirium. 

Sweating stage. — Sometime within twenty-four hours 
all the above symptoms mainly subside, and moderate 
sweating commences. The pulse drops ten or fifteen per 
minute, the headache and vomiting cease, and the fever 
falls about two degrees. This is called the remission, but it 
must be remembered that this stage is never free from fever. 

After several hours, the symptoms of the hot stage 
return, usually without the chill, this stage always being 
known as the exacerbation, which is followed again by the 
remission, the entire course of the disease being simply a 
series of exacerbations and remissions. 

Authorities differ regarding the duration of this fever, 
probably owing to the different localities in which they 
have practised, but the fever rarely gives way under four- 
teen days. Just in proportion to the darkness of the 
tongue, with red edges, is the tendency to typhoid, and 
sometimes at the end of about two weeks, when there is 
reason to hope for convalescence, the tongue takes on a 



REMITTENT FEVER. 99 

dark brown coating, lips become parched with a tendency 
to bleed, and a black, gum-like deposit appears upon the 
teeth, showing that the case has drifted into a malignant 
form of typhoid. 

Termination. — Usually favorable. 

Treatment. — The preponderance of authority favors the 
administration of quinine during the remissions, in order 
to break the force of the paroxysm and shorten the dura- 
tion of the disease. The author, during a very wide ex- 
perience with this disease in malarial districts of the west, 
followed the quinine treatment for a long time, giving 
about ten grains during each remission, and failed to note 
any decided improvement from such a course. On the 
other hand, quinine given in this way seemed to increase 
the headache and nervousness that usually attend the hot 
stage. In this way he was led to try the expectant plan of 
treatment, which simply means nothing, so far as medicine 
is concerned. It consists in waiting for the disease to run 
its course, while sweetened water, or something else equally 
valueless as a medicine, is given to satisfy the patient and 
friends. He found that most of the cases treated in this 
way ran a milder course, and were not a day longer in 
duration than those treated with quinine. In all cases, due 
attention was paid to the condition of the bowels, kidneys, 
and other organs of the body. There is really but little to 
do in the treatment of a case of bilious fever except to keep 
the bowels, skin, and kidneys in a healthy state. If there is 
irritability of the stomach it is best allayed by small doses 
of calomel, given in the following form : Mercurius dulcis, 
the first decimal trituration, twenty grains, to be divided 
into five powders, and one powder given every hour. The 
powders are to be placed in the mouth dry, and swallowed 



100 REMITTENT FEVER. 

with a tablespoonful of water. After they work off, which 
they usually do in ten or twelve hours, the irritability of 
the stomach and intestinal tract ceases. The urine is 
always scanty and high colored, with a tendency to blood- 
poisoning by retention of the salts that should be excreted 
by the kidneys. There are two ways to facilitate the 
action of the kidneys and get rid of the poisonous effects 
of the salts, that are one of the greatest sources of delirium 
in the severest types of fever. One is to give a diuretic to 
act directly upon the kidneys, and the other is to allow the 
patient to have all the water he can drink, in order to 
wash the salts out of the body through the kidneys. 
Hence the following : — 

Sweet spirits of nitre, two ounces, 

Acetate of potash, one-half ounce, 

Water, two ounces. 

Mix, and give a teaspoonful every two or three hours 
when awake. 

During the hot stage there is usually a great deal of 
thirst and, unless there is irritation of the stomach and 
bowels with a tendency to diarrhoea and vomiting, the patient 
ought to drink as much water as he desires. The use of 
the sponge bath during the hot stage has a tendency to 
lower the fever by the direct application of cold to the 
surface, and also by maintaining a healthy action of the 
skin and favoring perspiration. When delirium occurs in 
the hot stage, it is best controlled by the constant applica- 
tion of cold water to the head The practice of putting a 
wet towel on the forehead is bad, as it keeps the head hot, 
and does more harm than good. The water should be 
applied with a sponge very freely all over the head, satu- 
rating the hair thoroughly, and causing its rapid evapora- 
tion by the vigorous use of a fan. 



TYPHOID FEVER. IOI 



TYPHOID FEVER. 



Other names : enteric fever ; gastric fever ; nervous 
fever; abdominal typhus ; autumnal fever. 

This is an acute infectious fever that is self-limited. 

Causes. — It seems that the predisposing causes are age 
and heredity. It most frequently occurs between the ages 
of fifteen and thirty, and is rarely seen in those over 
fifty. 

Some families are especially liable to the disease, and 
this fact establishes heredity as a predisposing cause. 

A special germ or bacillus, known as the typhoid germ, 
is the exciting cause. 

The poison of typhoid fever, through which it is mainly 
propagated, is in the stools and expectorations. The at- 
mosphere is not impregnated with these germs, but the 
poison enters the system through food and water. The 
stools and expectorations should be disinfected with a solu- 
tion of carbolic acid, using about four tablespoonfuls of 
the acid to a quart of water. 

Symptoms. — The fever comes on gradually, preceded by 
several premonitory symptoms, such as dizziness, headache, 
especially in the back of the head, nervousness, with in- 
ability to sleep, deranged digestion, low spirits, and general 
weakness, followed by a chill or chilly feeling. When the 
patient comes under treatment he is wholly unable to tell 
when the attack began. In malarial districts, however, the 
disease occasionally sets in suddenly with a chill, followed 
by high fever. 

What is known as the premonitory or warning symptoms 
may last ten or twelve days, but usually this stage is much 
shorter. 



102 TYPHOID FEVER. 

During the first week of the fever, the temperature 
gradually increases, the pulse becomes more frequent, the 
coating of the tongue heavier, more headache, the abdomen 
enlarges, and there is tenderness in the right side and 
frequent gurgling of the bowels in that locality. About 
the end of the first week in the well-marked cases, a few 
reddish spots appear upon the chest, back, and abdomen. 

Daring the second week, all these symptoms increase in 
severity, the fever becoming higher, pulse more frequent, 
abdomen more distended, and frequently delirium at night. 
There is headache, more or less stupor, some cough, jerk- 
ing of the muscles, and dark accumulations upon the teeth, 
and there may or may not be diarrhoea. The coating often 
disappears from the tongue and the mouth becomes so dry 
that it is difficult for the patient to speak. Deafness fre- 
quently exists. 

During the third week, the fever becomes remittent. 
It continues quite as high in the evening but is decidedly 
lower in the morning, while all the other symptoms remain 
about the same. By the end of the third week, however, 
there is a general improvement. 

Unfortunately, in quite a number of cases, all the symp- 
toms grow worse during the third week, the tongue and 
lips becoming dry and cracked, both teeth and gums 
covered with a black deposit, called " sordes," the pulse and 
respiration quicker, the urine and stools are passed uncon- 
sciously, and the case ends fatally. 

In the great majority of cases, patients that survive 
until the fourth week without any of the desperate symp- 
toms referred to above, recover. Generally the symptoms 
of improvement set in during the third week, so by the 
fourth the fever is greatly reduced, being almost absent in 



TYPHOID FEVER. 103 

the morning, the pulse is less frequent and stronger, the 
tongue clean and moist, and a general but slow conva- 
lescence is established. Diarrhoea is usually supposed to 
be one of the most dangerous symptoms, but the author 
has found constipation to exist in many malignant types 
of the disease. 

Termination. — The favorable indications are, moderate 
fever, slight diarrhoea or constipation, and delirium, if at 
all, of moderate character. The most fatal period of the 
disease is during the third week. 

Treatment. — There are two great sources of danger in 
this disease. One is from ulceration of the bowels and a 
discharge of their contents into the cavity of the abdomen, 
causing fatal inflammation, death usually occurring within 
twenty-four hours. In order to prevent this termination 
it is best to keep the bowels in a state of perfect rest, if 
possible, so as to allow the ulcers, if present, to heal. For 
this reason the diarrhoea, if any, must be controlled, and it 
is much better in such cases if the bowels don't move for 
two or three days. To arrest the diarrhoea and keep the 
bowels in condition to favor the healing of ulcers, give the 
following : — 

Powdered opium, ten grains, 

Sugar of lead, twenty grains, 

Mix and divide into ten powders, and give one every five 
or six hours if needed. 

The second source of danger is exhaustion, caused by 
the intense fever and all the prostrating influences of the 
poison producing it; and just in proportion as the fever 
can be reduced in severity, the tongue and mouth kept 
moist, the accumulations upon the gums and teeth les- 
sened, the delirium prevented, and good refreshing sleep 



104 TYPHOID FEVER. 

procured, the danger will be diminished. A great deal of 
the delirium in typhoid fever is caused by a retention in 
the blood of certain salts that should be discharged by the 
kidneys. On this account it is best to keep up a gentle, 
stimulating action upon the kidneys during the entire 
fever, care being taken to avoid offending the stomach 
with too much medicine. To act on the kidneys give the 
following : — 

Sweet spirits of nitre, two ounces, 

Acetate of potash, a half ounce, 

Water, simple syrup, of each two ounces. 

Mix ; give a teaspoonful every three hours when awake. 

There is nothing so effectual in reducing the fever and 
controlling the distressing symptoms associated with it, 
as the direct application of cold to the body, and water 
is the best possible form in which it can be applied. If 
the water treatment is commenced in the early stage of 
the fever, while the patient is comparatively strong, the 
bath-tub is by far the best means of applying it. Experi- 
ence has proved that when the temperature in typhoid 
first reaches a hundred and two, it is best to put the 
patient in a bath-tub with the water at a temperature of 
about seventy, allowing the water to come up to his chin, 
while gallons and gallons may be poured upon his head. 
Meanwhile he is rubbed all over with a coarse towel, so 
as to excite the circulation of the skin. If not very weak, 
the bathing should be kept up for twenty minutes. This 
generally reduces the temperature from one to two degrees, 
and the most of the bathing should be done during the 
part of the day at which the temperature is highest. The 
injurious and prostrating effects of the fever are mainly 
due to the evening exacerbations, in which the temperature 



TYPHOID FEVER. 105 

is about two degrees higher than the rest of the day. 
This is when the secretions are dried up, when the tongue 
and lips become dry and parched, and the dark accumula- 
tions appear on the teeth and gums. 

If in every case of typhoid fever the temperature can be 
held down during three, four, or five hours of the evening 
aggravation, thousands of cases that would otherwise end 
fatally can be saved. There is nothing of any value in low- 
ering the temperature in such cases, but water. After the 
patient is taken from the bath-tub, should the fever soon rise 
again, water should be applied freely all over the body by 
a spray such as would flow from a small watering-pot. In 
order to apply water in this way, the patient should lie 
upon an oil-cloth or rubber sheet, and the waste water be 
lifted by a sponge. If, in spite of the frequent use of 
water in this way, the fever is not held down, a sheet 
dripping wet with cold water should be spread over him, 
and changed as often as necessary by dipping it again in 
cold water. The idea that must be kept in view is this : 
Whenever the temperature reaches a hundred and four 
or five for a few hours during every day, the tendency is 
very dangerous, and every possible effort must be made to 
reduce the fever and hold it down to one hundred and one 
if possible. Water must be used in the various ways 
mentioned above, and will often succeed when everything 
else fails. 

To prevent the chilly feeling and bluish color of the skin 
that sometimes occur during bathing, vigorous rubbing of 
the body with a moderately coarse towel is often necessary. 
After the temperature is reduced by water, the patient 
frequently falls into a refreshing sleep. 

If delirium of an active character exists, it is during the 



106 CEREBRO-SPINAL MENINGITIS. 

part of the day or night in which the fever is highest ; and 
it is best to have a wash-tub close to the side of the bed, 
hold his head over it with his face inclined downwards, and 
slowly pour several pitchers of water upon it, thoroughly 
bathing his hair and every part of the scalp. If not too 
exhausting, this should be kept up for ten or twelve 
minutes at a time. 

To secure refreshing sleep, the following may be given 
when necessary, and acts like a charm : — 

Fluid extract of valerian, a half ounce, 
Bromide of potassium, half an ounce, 
Water three ounces. 

Mix and give a teaspoonful, then turn down the lights, 
keep the room perfectly quiet, and he will usually fall 
asleep within an hour and may sleep all night. 

CEREBRO-SPINAL MENINGITIS. 

Other names : cerebro-spinal fever ; spotted fever ; 
cerebro-spinal typhus. This is a malignant fever, often 
prevailing epidemically, attended with terrible headache, 
vomiting, severe contractions of the muscles of the neck, 
extreme sensitive condition of the skin and muscles, caus- 
ing the patient to scream when handled ; frequent delir- 
ium, stupor, and more or less coma, with frequently an 
eruption of the skin in the form of dark red spots. 
Excepting the epidemic cases, the eruption that has given 
rise to the term " spotted fever," is not often found. The 
disease is due to microbes, resembling those found in 
pneumonia and erysipelas. Bad sanitary conditions seem 
to favor the development of the malady, which occurs 
most frequently in the winter, usually attacking children. 



CEREBRO-SPINAL MENINGITIS. 107 

Symptoms. — The common form begins suddenly with 
a chill, severe headache, nausea, vomiting, dizziness, and 
extreme weakness. In a short time, sometimes within a 
few hours, the muscles of the neck become rigid, with 
great pain upon moving the head, the rigidity or spas- 
modic action soon extending to the back, when the patient 
is curved in the back somewhat like a bow, and, like cases 
from strychnine poisoning, disposed to rest upon the but- 
tocks and top of the head. There are liable to be severe 
cramps in all the muscles of the body, especially the legs, 
and spasmodic twitching of the lips and eyelids. Con- 
vulsions frequently occur. Patients cannot bear the light ; 
deafness, with loss of smell and taste, are liable to follow. 
The eruption generally develops between the first and 
fifth day. The disease reaches its meridian in point of 
severity within eight days, gradually passes into a comatose 
state that is fatal, or improved symptoms show themselves, 
to be followed by a slow and tedious recovery. 

Termination. — Not very favorable, as more than half 
the cases die in a severe epidemic. 

Treatment. — The medical profession has always seemed 
to be at sea in the treatment of this disease and has never 
settled on any well-defined plan. The disease germ of 
spotted fever is similar to that of pneumonia, and like the 
pneumonic germ, develops a violent inflammatory fever, 
the pulse being, in the early stages, like the pulse of 
pneumonia. The experience of the author has shown that 
most cases of pneumonia, if treated early in the disease 
with veratrum veride, can be broken up within twenty-four 
hours ; that the fever, having been brought down, and 
with it the pulse to the normal standard, does not 
reappear, and the patient is actually restored to health. 



108 CEREBRO-SPINAL MENINGITIS. 

Therefore, as cerebro-spinal meningitis develops sud- 
denly like pneumonia, it has, like the latter, a proper 
period in which to give the same sedative, veratrum, which 
may be given in doses of the tincture as follows : From 
one-half to one drop every hour for five or six hours, com- 
mencing immediately after the initial chill. If, by this 
means, great sickness of the stomach with efforts to vomit 
occurs, the fever will very probably fall and the pulse 
also. The skin will become cold and clammy, drops of 
perspiration will stand upon the face and forehead, and 
the patient will seemingly be in a state of fatal collapse. 
In such cases a half tablespoonful of whiskey in a little 
sweetened water will hasten the reaction which always 
follows the use of veratrum in this way, whether the 
stimulant is given or not. Sometimes an attack of this 
disease is broken up by the timely employment of the 
sedative. In the great majority of cases, however, it does 
not succeed in aborting the affection, but it certainly 
breaks the force of the inflammatory action and lessens 
the organic changes that would otherwise follow. To put 
it in plainer language, it is calculated to modify the 
disease and cause it to run a more favorable course. 
After a reaction from the first effects of the drug, the 
veratrum should be resumed and given for a few hours, 
every hour as before, and then every two hours. By 
keeping the patient under the influence of this sedative 
more or less for forty-eight hours, which is really the 
formative stage of the disease, great good can be 
accomplished. 

It is believed that a great many cases that would other- 
wise result fatally can be saved in this way, that it renders 
the distressing effects of the blistering treatment unneces- 



SIMPLE CONTINUED FEVER. IO9 

sary, and prevents, to a considerable extent, deafness and 
permanent mental derangement. In such a malignant 
disease, however, it is not claimed that any treatment will 
save all the cases, but the sedative treatment as above 
given affords the greatest hope. The time may come, 
later in the disease, as it does where the sedative is never 
used, for a supporting treatment, such as tonics and stimu- 
lants. They are to be given as in weakened conditions 
from other diseases. 



SIMPLE CONTINUED FEVER. 

Other names : irritative fever ; ephemeral fever ; 
synocha ; febricula. 

This is a fever lasting from twenty-four to forty-eight 
hours, without any decided remissions, not the result of a 
specific poison, seldom fatal ; but when death occurs it 
shows no anatomical changes characteristic of the disease. 

Causes. — Anxiety, grief, overwork, mental or physical, 
mental perturbation, from whatever cause, but the most 
probable of all, excesses in eating and drinking, resulting 
in a distressing attack of indigestion. It belongs mainly 
to childhood. 

Symptoms. — The attack is sudden, often coming on 
with a chill, followed by a strong reaction and rapid rise 
of temperature, high pulse, dry skin, great thirst, foul 
tongue, bowels costive, urine scanty and high colored, 
usually headache and sometimes nausea and vomiting. 
The temperature is liable to rise to a hundred and three 
or more, and to be attended with delirium. 

Termination. — Almost always favorable, the disease 
running its course, as a general thing, in from twenty-four 



110 HAY FEVER. 

to forty-eight hours, but in some cases lasting six or seven 
days. 

Treatment. — If the symptoms of indigestion are promi- 
nent, and especially if there is diarrhoea or colicky pains in 
the bowels, give a five-grain powder of the first decimal 
trituration of mercurius dulcis, every hour, until five are 
given. Place the powder upon the tongue in a dry state, 
and wash it down with a tablespoonful of water. The 
powders will work off in eight or ten hours, and the gas- 
tric and intestinal disturbance will usually cease. 

Where there are severe nervous symptoms, with inability 
to sleep, the following can be given with the happiest 
results : — 

Fluid extract valerian, two drachms, 

Bromide potassium, two drachms, 

Water, three ounces. 
Mix and give from a half to a teaspoonful, according 
to the age of the child, at bedtime. 

HAY FEVER. 

Other names : hay asthma ; autumnal catarrh ; rose 
fever. 

This is a specific inflammation of a catarrhal character 
affecting the large air passages, including those of the 
nose, throat, and tubes of the lungs, with spasmodic con- 
traction of the muscular walls of the latter. The affection 
occurs in the latter part of summer or early autumn, and 
is attended with a flow of mucus from the nostrils, cough, 
and more or less difficulty of breathing. 

Causes. — The most common cause is an inherited pre- 
disposition to be morbidly sensitive to the perfume of 



HAY FEVER. Ill 

flowers or whatever it is that causes the affection. Persons 
in whom this tendency exists have paroxysms of hay fever 
that are supposed to be due to the inhalation of the pollen 
dust of various grasses, roses, or other flowers. 

Symptoms. — The first appearance of the trouble is fre- 
quently a flow of a watery mucus from the nose, the smart- 
ing of the eyes, sneezing, and sore throat. A little later 
the larynx and tubes of the lungs are affected, the voice 
becomes husky, and there is a wheezing cough with diffi- 
culty of breathing, the latter occurring in paroxysms like 
attacks of asthma. The affection is a series of paroxysms 
and remissions for a month or more, during which there is 
almost constantly an irritating bronchitis. After it is once 
developed it is liable to continue till cold weather destroys 
the pollen dust. It is impossible to tell what plant or 
flower exercises the most influence in exciting the disease, 
and it may be the combined effect of many flowers. 

Termination. — The affection in itself never proves fatal, 
but may develop incurable asthma and chronic bronchitis. 

Treatment. — The most satisfactory treatment is a change 
of climate each season before the hay fever sets in, and 
going to a high mountain climate where the fever-producing 
plants do not exist. Almost any part of the Rocky Moun- 
tains seems to afford a complete immunity from hay 
asthma. 

It is claimed that Dover's powder, given in six-grain 
doses three or four times in twenty-four hours, has often 
broken up an attack of hay fever. It is claimed that 
quinine in five-grain doses, given three times a day for 
several days and commenced two or three days before the 
expected attack, will prevent it. The paroxysms are al- 
ways relieved by the application of a four per cent solution 



112 RELAPSING FEVER. 

of cocaine to the nostrils by means of an atomizer. The 
application may be repeated every three or four hours 
during the day. If the effects of the drug wear off to 
some extent, the strength may be increased to a six per 
cent solution. 

RELAPSING FEVER. 

Other names : febris recurrens ; famine fever ; bilious 
typhoid. 

This is an acute, infectious disease, is contagious, epi- 
demic, and self-limited. The fever paroxysm lasts about 
six days, and then there is a complete intermission to be 
followed by a relapse, the second paroxysm being about 
the same as the first, both in duration and gravity. 

Cause. — A specific poison. It seems to flourish most 
extensively in the crowded, filthy, and unhealthy districts of 
cities. 

Symptoms. — It has no premonitory or warning symp- 
toms. The attack is sudden, the fever running up from 
one hundred and two to one hundred and four, pulse fre- 
quent and rather weak, headache, nausea, and vomiting, 
with sharp pains in the limbs and muscles, especially the 
legs. On the second day there is a feeling of fulness and 
pressure in the right and left sides, caused by swollen 
liver and spleen. The deranged function of the liver 
manifests itself by the appearance of jaundice. The first 
paroxysm ends on the seventh day in profuse perspira- 
tion ; the second ends about the thirteenth or fourteenth 
day, the symptoms being somewhat milder. There may 
be several relapses. 

Termination. — Generally favorable. 

Treatment. — The disease cannot be aborted by any 



TYPHUS FEVER. 113 

known treatment. Quinine has been used extensively to 
prevent relapses, but never succeeds. For the nausea and 
vomiting, and also to arouse the secretions, five-grain doses 
of mercurius dulcis, in the first decimal trituration, may be 
given every hour until four are taken. They are to be put 
in the mouth dry, and washed down with a tablespoonful 
of water. They will produce a slight action upon the 
bowels, and almost always allay the sickness. If there is 
great weakness during the last days of the affection and 
after the fever has subsided, quinine may be given in one- 
grain doses, and with each dose a tablespoonful of port 
wine. 

TYPHUS FEVER. 

This fever is known by a half-dozen different names, 
as follows : ship fever; contagious fever ; jail fever; pe- 
techial fever ; exanthematic typhus ; spotted fever. 

It is an acute, epidemic disease, very contagious, devel- 
ops suddenly, characterized by extreme depression of the 
vital powers, disagreeable odor, an eruption of rose-colored 
spots, sometimes being but few in number, while in other 
cases they cover the entire body so thickly that they al- 
most touch each other. The favorable cases terminate in 
about fourteen days in profuse sweating. The disease is 
due to a germ regarding the nature of which but little is 
known, and yet it is unfavorably influenced by bad sanitary 
conditions. 

It is rarely seen in the United States, except among 
recently arrived emigrants, and soldiers in the army. The 
author, who was an army surgeon, saw a great many cases 
in the General Field Hospital, Atlanta, Georgia. 

Symptoms. — Commences with a chill, followed by in- 



114 YELLOW FEVER. 

tense fever, the temperature frequently reaching a hun- 
dred and five F. within a few days, pulse rapid and bound- 
ing, soon becoming small and weak ; severe headache and 
usually delirium. From the fifth to the seventh day, red 
spots appear on the skin that do not disappear on pressure ; 
there is great prostration, dizziness, trembling of the hands, 
also tremor of the muscles, and generally constipation of 
the bowels. Within about two weeks the temperature 
subsides suddenly, followed by a speedy recovery. 

Termination. — In many cases unfavorable, except when 
the disease occurs in youth under somewhat favorable 
sanitary conditions. The best authorities agree that the 
mortality ranges from five to thirty-five per cent. 

Treatment. — As the disease is emphatically contagious, 
each patient should be isolated to prevent contagion. 

The high fever is best controlled by cold sponging, the 
cold wet pack, or by putting the patient in the bath-tub. 
When placed in the tub a gentle shower of water upon the 
patient, 'the temperature being that of summer heat, will 
give the happiest results. The bath may be continued 
for ten or fifteen minutes at a time, if the patient is not 
too weak. For the great debility, brandy or whiskey may 
be given every half hour in doses of one or two teaspoon- 
fuls. 

YELLOW FEVER. 

Other names : bilious malignant fever ; Mediterranean 
fever; yellow jack; sailor's fever ; black vomit. 

This is an acute disease, characterized by paroxysms, and 
having three stages, the fever, the remission, and the col- 
lapse. It is an infectious disease, attended with violent 
fever, yellowness of the skin, and black vomit. The af- 



YELLOW FEVER. 115 

fection is not contagious, but prevails as other disorders, 
the infection through which it is propagated being due to 
a vitiated atmosphere. It is said that one attack of this 
disease affords an immunity from a second. 

Symptoms. — The first stage, which is the fever, may 
have a premonitory or warning stage in which there is a 
dull, stupid condition and more or less headache, or it 
may commence abruptly with a chill, followed in two or 
three hours by a fever ranging from a hundred and two to a 
hundred and six F. The pulse may rise to one hundred 
beats per minute, the eyes becoming glossy, the countenance 
flushed, tongue coated, and the stomach irritable. There 
are often severe neuralgic pains over most of the body, 
especially in the large joints and region of the stomach. 
In the severest cases there is delirium. As in all fevers, 
the urine is scanty and high colored. The duration of the 
first stage is from thirty-six hours to three or four days. 

The second stage is that of the remission, in which the 
temperature falls almost to the normal point, and there is a 
relief of all the distressing symptoms, convalescence being 
established ; or, in more unfavorable cases, the third stage, 
that of collapse, or the period of secondary fever, com- 
mences within three days, and is marked by all the symp- 
toms of the first stage in an aggravated form ; the skin 
becomes yellow and finally changes to a dark brown, cof- 
fee-ground vomit, pulse feeble, surface cold, breathing 
irregular, death occurring from exhaustion. 

Termination. — The mortality is about one in four. 

Treatment. — The disease is self-limited. Patients should 
be made as comfortable as possible in a good bed, the sick- 
room being provided with an abundance of fresh air ; and 
to guard against the irritable stomach that usually follows, 



Il6 YELLOW FEVER. 

the bowels should be moved gently with small doses of 
mercury, and what is the best form and most efficient in 
allaying gastric and intestinal irritation, calomel, tritu- 
rated in sugar of milk, one grain of the calomel to nine 
grains of the sugar of milk. The trituration should be 
very thorough, or, in plainer terms, they should be ground 
together for about fifteen minutes in a mortar. Of this 
trituration give a five-grain powder every hour until five 
are given. Each powder must be placed in the mouth 
dry, and washed down by a tablespoonful of water. Calo- 
mel thus subdivided by being mixed with the sugar of 
milk acts as a physic by arousing the secretions of the 
whole intestinal tract, while its secondary effect is healing, 
soothing, and quieting. In dealing with a disease that is 
always attended with an irritable stomach, it is best to 
anticipate it and use such treatment as is necessary to pre- 
vent its occurrence. In all such cases, in addition to the 
mercurial treatment to prevent vomiting, the use of water 
should be limited in quantity to a teaspoonful every half 
hour. 

The practice of giving patients small quantities of ice 
to slowly dissolve in the mouth, and in that way allay the 
thirst, is " dead wrong," for two reasons : In the first 
place, after it is once fairly commenced it must be con- 
tinued through the fever, to avoid the terrible reaction and 
thirst that would follow if it were left off. In the second 
place, the ice, by constantly melting in the mouth, soon 
gets entirely too much water in the stomach, which is 
liable to excite both vomiting and purging. Should mer- 
cury given in this way fail to arrest the vomiting, morphine 
may be given in one-fourth-grain doses, or, in the severest 
cases, three-eighths of a grain may be given. In order to 



PERNICIOUS FEVER. WJ 

succeed with this, a great deal depends on the way in 
which it is given. If swallowed during a fit of vomiting, 
or when there is water in the stomach, it will probably be 
rejected. 

Immediately after a spell of vomiting, the stomach is 
supposed to be entirely empty, and this is the proper time 
in which to give the morphine pill. If it is placed on the 
tongue, well back, and a teaspoonful of water given to 
wash it down, it will be difficult for the patient to throw it 
up, and in twenty minutes it will be absorbed by the 
stomach and the sickness will be over. The great objec- 
tion to morphine as compared with mercury in these cases 
is that in ten or fifteen hours, if not sooner, the sickness 
comes on again and is often attended with nausea and 
vomiting, solely due to the effects of the drug, and is 
known to doctors as "morphine sickness," and there is 
nothing that will allay it. The only remedy is to wait 
until the effects of the drug die out, which is sometimes 
forty-eight hours. 

PERNICIOUS FEVER. 

Other names : congestive fever ; malignant remittent 
fever ; malignant intermittent fever. 

This is an exceedingly malignant malarial fever, and 
may be either of the remittent or intermittent form. It is 
attended with great congestion of one or more internal 
organs, with violent nervous action, followed by nervous 
debility. 

Cause. — An excessive amount of malarial poison. 

Symptoms. — The disease may commence in any of its 
forms, either as a remittent or an intermittent fever. The 



Il8 PERNICIOUS FEVER. 

first paroxysm usually appears as an ordinary malarial 
attack. 

The gastro-enteric variety of the disease is the one in 
which the stomach and bowels are greatly affected, and is, 
consequently, attended with intense nausea, vomiting, and 
purging, the discharges being thin and mixed with blood. 
There is a painful desire to go to stool, burning heat in the 
stomach, great thirst, pulse frequent and weak, feet and 
hands cold and shrunken, and great vital depression. This 
condition may continue for several hours, followed by either 
an intermission or a remission. 

The thoracic form may have most of the above symp- 
toms, and, in addition, there is great congestion of the 
lungs, in which suffocation is threatened, the patient gasp- 
ing for breath, and breathing fifty times per minute, or 
more. There is a desperate effort to cough, and the ex- 
pectoration is often streaked with blood. The pulse is 
weak and rapid, and surface cold. The chill may last for 
several hours. 

The cerebral or brain form is caused by great conges- 
tion of the brain, sometimes by accumulation of water in 
the cavities, or by rupture of small blood-vessels of the 
brain. This form is attended by terrible delirium with 
stupor and coma, the pulse full and a s1ow, the surface 
flushed. As the hemorrhage of the brain is truly apo- 
plexy, there is a great tendency to fatal coma. Duration 
of chill, from one to four hours. 

The hemorrhagic variety begins as a common remittent 
or intermittent fever, and is soon succeeded by symptoms 
of internal congestion. Nausea, vomiting, threatened suf- 
focation, intense pain over liver and kidneys, continue for 
two or three hours, when the skin suddenly turns yellow 



PERNICIOUS FEVER. 119 

and the urine bloody. The bloody urine has given rise to 
the name " hemorrhagic form." After the yellow skin and 
bloody urine appear there is a remission or intermission, to 
be followed sooner or later by another and severer paroxysm. 

The algid form is so named because the word " algid " 
signifies cold. It is characterized by extreme coldness of 
the surface, while the internal temperature of the body 
may reach one hundred and seven F. The attack, 
which begins with a chill, is soon followed by a fever of 
uncertain duration, and when it subsides, the temperature 
of the body falls to ninety, and sometimes even to 
eighty-five F. ; there is a cold sweat, the tongue is 
white, the breath is icy cold, voice weak, pulse slow and 
feeble, sometimes imperceptible, and notwithstanding all 
these symptoms of extreme cold the patient complains 
of a burning thirst. The mind is clear, but the counte- 
nance is ghastly. 

Termination. — In all its forms it is unfavorable, unless 
it is controlled prior to the second paroxysm. Those cases 
in which a complete intermission occurs are more favorable 
than where there is only a remission. Under the best 
treatment and best management it is calculated that from 
twelve to fifteen cases in a hundred end fatally. 

Treatment. — In all the forms of this disease the first 
and most important thing to be done is to establish a 
reaction as soon as possible. Stimulants are to be used 
internally and heat applied to the surface with a view of 
modifying or shortening the cold stage. In the hot stage, 
cold water is to be applied freely to the surface by means 
of a sponge, and using a fan to hasten the evaporation and 
cause the absorption of the heat. 

The terribly distressing symptoms of the hot stage are 



120 PERNICIOUS FEVER. 

best controlled by a full dose of morphine, and of this, 
most patients will bear three-eighths, if not a half grain at a 
single dose. As soon as an intermission or remission of 
the fever occurs, sulphate of quinine should be given, and 
as the time may be limited in which it is possible to give 
it, at least twenty grains should be given at a single dose, 
to be followed in two hours by another dose of equal size. 
There is a difference of opinion among authors regarding 
the proper time in which to commence the quinine treat- 
ment. Some wait for an intermission or a remission, 
while others favor giving it as soon as the reaction is 
established. The latter plan is doubtless the safer course, 
as it is not known how soon the second chill, which is 
usually fatal, may occur. 

Like all other terrible diseases, a multiplicity of remedies 
are suggested for congestive fever, and formulas contain- 
ing a dozen, and sometimes even twenty different drugs, 
are found in the text-books. The curative value of all 
such prescriptions depends almost absolutely upon one 
drug, and that is quinine. Such large combinations are 
liable to offend the already irritable stomach, and for that 
reason it is decidedly better to limit every prescription to 
such remedies as have beyond question the greatest cura- 
tive action. 

When a many-drug prescription is made to stop vomiting, 
it almost always contains mercury in some form, as that 
drug is known to cover a wider range of such affections 
than any other drug. In such cases the curative action of 
the only valuable remedy in the prescription is often 
ruined by irritating and useless drugs, and the stomach 
rejects them all. 

Therefore, in the gastro-enteric variety of this disease, 



SCARLET FEVER. 121 

it is better to allay the vomiting with small doses of calo- 
mel as follows : — 

The first decimal trituration of mercurius dulcis, twenty- 
grains. Divide into five powders, and give one every hour 
until the sickness is relieved. Give each powder dry, and 
as soon as it is in the mouth, give a tablespoonful of water. 

If the mercury fails to allay the vomiting, a one-fourth- 
grain morphine pill may be given, using the smallest amount 
of water necessary for swallowing. If vomiting is the only 
distressing symptom, a quarter-grain pill may be sufficient; 
but there is usually a great deal of pain and irritation in the 
bowels, and the dose may have to be repeated in a half 
hour. Therefore it is better in most cases to give three- 
eighths of a grain to commence with. 

SCARLET FEVER. 

Other names : scarlatina ; scarlatto. 

This is an acute, contagious, infectious disease, essen- 
tially belonging to childhood, attended with high tempera- 
ture, rapid pulse, and a scarlet eruption covering the 
entire body. There is inflammation of the mouth and 
throat, and also of the glands of the throat and jaw. It 
has what is called a desquamation stage following the 
fever, and during which the entire cuticle separates from 
the underlying skin. In other words it peels off. One 
attack affords an immunity from others. 

Cause. — A specific poison. At present the informa- 
tion regarding the character of the specific germ is con- 
flicting, but it seems to be a parasite, the nature of which 
has not been satisfactorily determined. 

Scarlet fever ranges in point of severity from cases that 



122 SCARLET FEVER. 

are so mild as to attract but little, if any, attention to 
those of the severest and most fatal type. 

The development is usually sudden, and commences 
with a marked chill and vomiting. There is pain in the 
throat followed by a high fever, the pulse being very rapid. 
Within twenty-four hours the eruption appears, which is 
a bright scarlet, giving rise to the name of the disease, 
"scarlet fever." The rash, which appears first on the 
neck and chest, spreads over the entire body in a short 
time. At this time there is burning heat of the skin, 
pain in the throat, and difficulty in swallowing. On exami- 
nation the throat is found red and inflamed. The head- 
ache and restlessness are great, and there is frequently 
delirium. Diarrhoea is a frequent complication. 

Within four or five days the fever declines and with it 
the eruption fades, when the cuticle begins to separate 
from the skin. This process may cover a period of two or 
three weeks. The patients are thin and pale, and recovery 
very slow. 

Termination. — Always more or less unfavorable, as the 
disease is a grave affection, the mortality ranging from 
fifteen to twenty-five children in a hundred. 

Treatment. — The medical profession knows no remedy 
that will abort the disease ; in other words it is impossible 
to break it up until it runs its course. The treatment 
consists, mainly, in treating the symptoms as they occur. 

As it is highly contagious, each patient should be sepa- 
rated from other members of the family, with room well 
ventilated and disinfected. The fever and inflammatory 
condition of the skin are best controlled by cooling drinks 
and frequent sponging with water at a temperature of about 
eighty F. The wet pack is often used as a substitute for 



SCARLET FEVER. 1 23 

the sponging, and a great deal is claimed for it in keeping 
down the fever and carrying the patient along to a favor- 
able termination. Water, if not actually a sovereign balm 
in scarlet fever, is certainly one of the best remedies. 
During the high fever great benefit may be obtained from 
the use of aconite, as follows : Tincture aconite, ten drops, 
water, forty teaspoonfuls. For children from two to six 
years old, give a teaspoonful every hour. In cases attended 
with great fever, throbbing of the arteries of the neck, and 
wild delirium, very small doses of the tincture of bella- 
donna may be given with benefit. A convenient way to 
give the drug is as follows : Put four drops of the tincture 
in a glass of water, and give a teaspoonful every hour. 
Aconite, as above recommended, may be given at the same 
time, so as to bring one dose of the latter between the 
doses of the belladonna. As soon as the eruption appears, 
rub the patient's entire body, except the scalp, with vase- 
line, night and morning. The most happy effect of the 
ointment is quieting the irritation of the skin, and in pro- 
portion as this is effected, the inflammatory action and the 
fever are reduced. Later in the disease, usually during 
the " peeling-off " process, there may be a great deal of 
itching. If the. simple ointment does not allay this itch- 
ing, it is best to add ten drops of pure carbolic acid to two 
ounces of the vaseline, and thoroughly mix. In some cases 
the venice turpentine acts better than the carbolic acid. 
When it is used, one drachm may be mixed with two 
ounces of the vaseline. It is hard to tell when a patient 
is out of danger with scarlet fever, as it is attended with 
many complications, some of them commencing after the 
patient seems to be almost well. One of the serious 
phases of the affection is the inflammatory and enlarged 



124 SCARLET FEVER. 

condition of the glands about the throat. This, conjoined 
with the accumulations of mucus in the mouth and air 
passages, greatly embarrasses respiration, causing blood 
poison, and in that way hastening a fatal ending of the 
case. The swelling of the glands, as a general thing, is 
best reduced by the use of hot cloths, changed every two 
minutes, and applied for about fifteen minutes at a time, 
and repeated every two hours. The cloths are to be 
dipped in water as hot as the patient can bear. Instead 
of this, hot flaxseed poultices, changed every half hour 
and continued eight or ten hours at a time, may rapidly 
reduce the swelling. Sometimes these enlarged glands 
cannot be reduced to any great extent by any treatment, 
but obstinately continue through the entire acute stage, and 
suppurate. In other words, they "break," or have to be 
lanced. These abscesses developing in the advanced 
stage of the disease, may lead to a fatal termination from 
exhaustion and blood poisoning. In such cases the follow- 
ing tonic may be of great benefit : — 

Fluid extract of cherry-tree bark, 

Fluid extract of peruvian bark, of each a half ounce, 

Sulphate of iron, thirty grains, 

Port wine, fourteen ounces, 

Simple syrup, one ounce. 
Mix, and give a half tablespoonful three times per day. 
The irritation of the bowels attended with diarrhoea, with 
or without sickness of the stomach, is best controlled by 
the first decimal trituration of mercurius dulcis in five-grain 
powders, one powder being given every hour until five are 
given. These powders are always to be put in the mouth 
in a dry state, and washed down with a little water. This 
is the best treatment for the irritation of the stomach and 



MEASLES. 125 

bowels, at whatever time it may occur during the course 
of the disease. 

There is always a tendency to disease of the kidneys 
in scarlet fever. This is probably due to an extra amount 
of work they have to perform in order to compensate for 
the suppressed action of the skin. In this way they may 
become "tired," as it were, and need stimulating. 
For this purpose give the following as directed : — 
Sweet spirits of nitre, one ounce, 
Acetate of potash, two drachms, 
Simple syrup, water, each an ounce and a half. 
Mix, and give a teaspoonful every three hours. 



MEASLES. 

Another name : rubeola. 

This is an acute disease, communicated by contagion. 
It commences with the symptoms of a very severe "cold." 
There is usually a cough and a flow of mucus from the 
nose, considerable fever, loss of appetite, and a miserably 
bad taste in the mouth, so that food of every kind is dis- 
agreeable. 

Cause. — A specific poison, or a poison that is sure to 
produce in all cases the same kind of disease. The attack 
almost always protects a person from another. 

Symptoms. — The disease comes on gradually, and from 
the time of the first premonitory symptoms until the rash 
appears on the body, is sometimes four days. Where 
persons are exposed to cold, or get wet during the warning 
symptoms of the affection, the eruption is liable to be 
delayed, which greatly aggravates the distress. During 



126 MEASLES. 

this prodrome there may be a decided chill, but as a gen- 
eral thing it is only a chilly feeling, followed by fever, the 
temperature sometimes rising to one hundred and two, or 
more. There is soreness over most of the body, with 
headache and all the symptoms of acute catarrh. The 
eyes are deeply reddened and watery. On the second day 
the fever subsides to a great extent, but the catarrh con- 
tinues. Usually on the fourth day a deeply red eruption 
occurs on the face and chest, soon spreading over the 
whole body. The fever always returns with the appear- 
ance of the eruption, and as the latter affects the mucous 
membrane as well as the skin, the catarrh is aggravated, 
the discharge from the nose changing from the watery 
form to a thick and heavy mucus that may be a cream 
color. The catarrh also extends to the mucous membrane 
of the air passages. On the ninth or tenth day, the erup- 
tion fades. The cuticle curls up and separates from the 
true skin, but not to the extent that it does in scarlet 
fever. 

The disease is frequently attended with pneumonia, and 
when it proves fatal in children, death is mostly due to 
pneumonia. 

Termination. — Generally favorable, but sometimes re- 
covery is slow and attended for weeks with a distressing 
cough. The disease is one of the exciting causes of con- 
sumption, and when this complication occurs it is almost 
always unfavorable. 

Treatment. — The mild cases require no medicine what- 
ever. In the winter season, patients should be protected 
from draughts of cold air and in that way avoid taking 
cold. If the fever is very high, give the following every 
hour : — 



VACCINATION. 1 27 

Tincture of aconite, ten drops, 
Water, four ounces. 

Mix. Dose, a teaspoonful to be given every hour until 
the fever is properly controlled. 

Should pneumonia occur, it should be treated in the way 
laid down for the management of that disease. The itch- 
ing of the skin that is sometimes very annoying may be con- 
trolled by the free application of vaseline, but if the simple 
ointment fails to stop the itching, five drops of carbolic acid, 
added to each ounce of vaseline, will stop it almost instantly. 
After the fever has all subsided, the eruption faded from 
the skin, and the peeling-off process is under way, there is 
yet great danger from exposure to cold, and fatal lung 
complications may arise from getting caught out in a rain. 

VACCINATION. 

When the teat of a cow is scratched in the proper way 
so as to bleed slightly, and matter and lymph are taken 
from a case of smallpox and applied to the cow's teat 
about as vaccine matter is to a person's arm, the cow 
takes smallpox. As the animal is much less susceptible 
to the poison than a human being is, the virulence or 
severity of the disease is greatly reduced, so that a scab 
taken from the cow and used in vaccinating children affects 
them in a greatly modified form, manifesting- itself in a 
group of symptoms familiar to every person who has seen 
a case of vaccination. The cow vaccine is very properly 
called the nonhumanized vaccine matter. When a person 
is vaccinated for the first time with the cowpox matter, 
fresh from the cow, such person is liable to encounter all 
the severe symptoms, and enjoy all the protection obtain- 



128 VACCINATION. 

able from any vaccination. As syphilis and other consti- 
tutional diseases cannot be communicated to man through 
a cow, it is evident that the horrible dread of contracting 
the bad disorder from cowpox is not warranted. It is 
true that a great many complications arise from the use 
of the cowpox matter, and sometimes there are extensive 
sloughings of the arm, attended with unsightly scars. In 
all such cases the patients are themselves scrofulous, or 
tainted with some constitutional disease that is simply 
excited by the vaccination. These cases, even though 
they rarely occur, have given rise to a foolish and absurd 
opposition to vaccination. 

After a person is once effectively vaccinated, whether in 
childhood or not, it is a matter of some doubt whether it is 
ever necessary to repeat it, but in order to be on the safe 
side it is thought better where persons are vaccinated in 
childhood to have them vaccinated again after maturity. 
The author was vaccinated in boyhood,- and when he was 
twenty-four had the varioloid. The fever was considera- 
ble, the headache and backache were terrible, the eruption 
very slight, and the whole trouble subsided in forty-eight 
hours. The best way to perform the operation in vacci- 
nating is as follows : First, take the scab and put it on 
the bottom of a plate and add a drop of water to it, then 
break it up with a table knife so as to get it into a watery 
paste. Next, take a common lance, dip it quickly in boil- 
ing water, wipe it dry, and make four or five light cuts 
through the skin of the arm, about the sixteenth of an 
inch apart. These cuts should be deep enough to cause 
a very little bleeding, then cross them at right angles 
by an equal number of cuts made in the same way. 
After this is done, scrape off the blood, and rub the check- 



SMALLPOX. 1 29 

ered surface over thoroughly with the pasty matter, using 
the lance for this purpose. 

In this operation a great deal depends on the extent of 
the surface to which the matter is applied. If it is large, 
more matter will naturally be absorbed, a larger surface 
affected, and a larger and deeper scab, with more fever 
and greater protection, will be the result. If done as 
above directed with fresh cowpox matter, the protection 
in the large majority of cases will be perfect. 

Symptoms. — In successful cases of vaccination a papule 
or pimple appears about the third day. By the sixth day 
it is matured into a vesicle containing a pasty lymph, and 
becomes depressed at the centre. On the eighth or ninth 
day it becomes a fully formed pustule, the surface sur- 
rounding it for an inch or more in every direction being 
deeply red and inflamed. The color begins to fade by the 
tenth day, the pustule dries, and in four or five days more 
is a dark brown scab. In from twenty to twenty-five days 
it drops off. The color of the scar fades from red to the 
natural color of the skin, finally becoming white, with a 
number of those indentations characteristic of smallpox. 

SMALLPOX. 

Another name : variola. 

This is an acute disease, and intensely contagious. It 
commences with the severest aching pains imaginable, in 
the lower part of the back. There is no possible position 
in which the patient can sit, stand, or lie, that affords any 
relief. The fever that marks the beginning of the attack 
lasts from three to four days. As this fever and terrible 
distress in the back begin to subside, the eruption char- 



130 . SMALLPOX. 

acteristic of the disease gradually makes its appearance, 
and has three distinct stages. First, papular or pimple- 
like. Second, vesicular, in which they contain fluid. 
Third, pustular, in which they are full of white matter. 
From first to last they are called " pustules." During their 
development another fever comes on which is called the 
" secondary fever." 

Cause. — A specific poison, the nature of which is un- 
known, that retains its specific contagious energy for 
months. The poison is the most contagious known in 
medicine. An infected sheet of writing-paper would 
breed a case of smallpox after going round the world. Its 
period of contagion lasts from the earliest appearance of 
the fever until it has passed through all of its stages, 
until the scabs have all fallen from the skin and the latter 
is entirely sound and free from irritation. The stage of 
suppuration is the one in which contagion is greatest. 
One attack usually protects a person from another. Vac- 
cination in the great majority of cases affords absolute 
protection, the cases being few, where it is properly per- 
formed, that will have it at all. The period of incubation 
is from fourteen to sixteen days. 

Symptoms. — It commences with a terrible chill, sick- 
ness of the stomach, and intense aching pains in the back, 
especially in the lower part. The fever rises rapidly ; the 
pulse is full, bounding, and frequent, like the inflammatory 
pulse. The face is red, eyes red and suffused, severe 
headache, extreme restlessness, and great debility. Active 
delirium is a frequent symptom in this stage of the dis- 
ease. The characteristic eruption appears on the third or 
fourth day, commencing first on the face. 

The eruption consists of plump, red spots about the size 



SMALLPOX. 131 

of bird shot, rising about half the diameter of such shot, 
above the level of the skin ; they feel hard under the finger 
until they pass into their second stage. All the prominent 
and distressing symptoms either subside or become greatly 
modified on the appearance of the eruption, and the pa- 
tient is somewhat comfortable. About the fifth day the 
spots are papular, or pimple-like. By the sixth day they 
are vesicular and filled with fluid and soon become de- 
pressed in the centre, as is the case with a vaccine pustule. 
By the eighth day the vesicles are changed to pustules, 
that is, they are filled with pus instead of watery lymph. 
By the ninth or tenth day the pustules are fully matured, 
and the features are terribly swollen and distorted. By 
the eleventh or twelfth day, pus, more or less mixed with 
pasty lymph, runs out of the pustule and dries into a firm 
crust, giving a crustaceous character to all scabs. During 
the suppurative stage of the disease there is a terrible 
fever, called the " fever of suppuration." This is the most 
distressing and critical period of the disease, the delirium 
being of the wild and violent type. The fever begins to 
subside in three or four days, if the case is inclined to a 
favorable termination, and recovery commences. 

The confluent form of smallpox is the one in which the 
pustules are so close together that they run into each 
other, and the malignancy of the disease is almost always 
in direct proportion to the amount of surface that is in~ 
volved in the pustules; therefore the confluent form is 
exceedingly grave, and should a patient recover he is so 
horribly disfigured as to make life undesirable. 

In the most malignant form of the disease, death results 
before the characteristic eruption makes its appearance. 
It seems that this is a much more desirable termination 



132 SMALLPOX. 

than recovery from the confluent form with the features 
terribly distorted. 

Termination. — Much depends upon the character of the 
epidemic, the variety of the attack, and the age of the 
patient. 

The discrete variety, or that form in which the pustules 
do not run together, is comparatively mild, the deaths num- 
bering about five in a hundred. In the confluent form at 
least one-half die. It is claimed that in cases of smallpox 
under five years old and over fifty, one-half die. In the 
malignant form not one survives. 

Treatment. — As the period of incubation of smallpox is 
from fourteen to sixteen days, that is, it takes from fourteen 
to sixteen days after exposure until the attack commences, 
and the period of incubation from vaccination is only a 
little over half that, if the patient is vaccinated immediately 
after the exposure, the vaccination will have time to run its 
full course before the real smallpox sets in, and for this rea- 
son an opportunity is afforded for a great deal of protection. 

Experience has abundantly proven that smallpox is ma- 
terially modified by vaccination performed in this way. 
During an epidemic in the west in which the author 
treated nearly a hundred cases of smallpox in the various 
forms, he saw that vaccination performed immediately after 
exposure, modified the real disease at least fifty per cent. 
In other words, the cases in which vaccination was per- 
formed were not more than half as severe as those not 
vaccinated at all. If, however, the vaccination is not per- 
formed until several days after the exposure, the chances 
of its affording much if any protection are very small. In 
the epidemic above referred to, the author was called to 
visit a lady, five miles out of town, with an eruption somewhat 



SMALLPOX. 133 

suspicious. At that time no cases except varioloid had 
shown up in that part of the country, and those had been 
mistaken for chicken-pox. On arriving at the house of the 
lady, a party of about thirty young people were present and 
arranging for a ball. Sitting close to a wood fire was the 
patient, with a heavy shawl around her, broken out all over 
the face, neck, and hands, with smallpox. The dancing 
party were arranging the large dining-room for an all-night 
dance. When it was positively announced that the lady had 
smallpox, the crowd of young folks actually fell over each 
other trying to get out of the house, and were terribly panic- 
stricken and demoralized. On examination it was found 
that about one-half of them had good vaccine marks, and 
that something like one-third of them had not been vacci- 
nated at all. The whole crowd went to town that night 
and the next morning, and were vaccinated. Those having 
a good vaccine mark upon the arm did not take the small- 
pox at all, while with the others, the disease, though more 
or less severe, was greatly reduced in severity by vacci- 
nation. There was not a solitary case of the confluent 
form from this exposure. None of the cases were disfig- 
ured to any extent by pitting, due, perhaps, to the careful 
use of a mask to be hereafter described. 

During the first stage of the disease, the distress from the 
fever and intense aching of the back and head, anti- 
pyrine may be given in doses ranging from twelve to fifteen 
grains, repeated every two hours until patient is relieved. 
For sleeplessness give the following : — 

Bromide potassium, one-half ounce, 
Fluid extract valerian, one-half ounce, 
Water, three ounces. 
Mix, and give a teaspoonf ul at bedtime and repeat it in five 



134 SMALLPOX. 

or six hours if necessary. The above is for an adult. For 
children over two years old, the dose is from one-eighth 
to one-half of that for adults, according to the size and age 
of the patient. The most critical period of the disease is 
during the secondary fever and is caused, largely, by blood 
poison, and of course is pyaemic in character, that is, it is 
due to absorption of pus from the hundreds of pustules 
covering the body. This stage is attended with extreme 
depression, and liable to fatal exhaustion. It calls loudly 
for tonics and stimulants, especially iron and brandy. A 
convenient tonic containing iron may also contain the best 
alcoholic stimulant, and hence the following : — 

Fluid extract Peruvian bark, 

Fluid extract wild cherry bark, of each an ounce, 

Sulphate of iron, forty-five grains, 

Brandy, one pint. 
Mix, and give a tablespoonful four times in twenty-four 
hours. 

During high fevers of any kind, patients have a craving 
for liquid food ; and it is fortunate they do, for the dry, 
solid foods, like meat, could not be properly digested. 
The appetite in such cases is an important guide in the 
selection of diet, and patients usually crave chicken broth, 
milk, soft-boiled eggs, and such other articles as are easily 
digested. 

TO PREVENT PITTING. 

The following is the description of a mask that should 
be applied to the face of every person with smallpox as 
soon as the eruption commences. Make it of two thick- 
nesses of heavy, black muslin, and large enough to cover 



SMALLPOX 135 

every part of the face, from the edge of the hair on the 
forehead to beneath the chin. It must be secured to the 
face by elastic bands passing round and over the head, so 
as to make it bear as firmly as possible upon every part of 
the skin it covers. 

It must have four openings : one for each eye, one for 
the nostrils, and one for the mouth. When ready to apply, 
it is to be covered with a paste or salve made as follows : 

Carbonate of zinc, three ounces, 

Oxide of zinc, one ounce, 

Olive oil, a sufficient quantity to make a salve soft 
enough to spread nicely. 

After the salve is spread over every part of the mask, it 
is then to be firmly secured to the face. It must be 
obvious to every one that the mask cannot touch the sides 
of the nose nor the parts of the cheek close to the nose. 
In order to overcome this defect, a considerable amount of 
cotton batting must be crowded in between the two sheets 
of muslin on each side of the nose so as to force the paste 
down upon every part of the skin. The mask should not 
be removed until all the scabs are ready to drop off. Any 
scabs that are pulled off before they are ready to drop off 
themselves, increase the pitting and deformity of the features. 

The author has used this form of mask through two 
great epidemics of smallpox, in which it was probably 
applied to forty patients, knows what it accomplishes when 
properly used, and has this to say : If made, applied, and 
worn as directed, it will almost entirely prevent pitting 
except in the worst forms of the disease known as con- 
fluent smallpox. In this form the scabs are so thick that 
they touch each other, and every one that has it is to be 
pitted. 



136 ERYSIPELAS. 

A separate mask should be kept on the neck from first 
to last, and the ears must be kept covered with the paste. 



ERYSIPELAS. 

This disease has a number of other names, some pretty 
large and rarely used. They are as follows : erysipelatous 
dermatitis ; the rose ; Saint Anthony's fire. 

It is an acute, specific disease, strongly infectious, 
attended with a fever of low type and scarlet inflammation 
of the skin, usually affecting the head and face. The 
inflammation is inclined to spread, sometimes rapidly, the 
skin becoming swollen and greatly congested. The glands 
of the neck and jaw are often greatly enlarged, so as to 
endanger life from suffocation. 

Cause. — A specific poison. Instead of one attack afford- 
ing an immunity from other attacks, one attack actually 
predisposes to another. 

Symptoms. — The disease usually has an abrupt com- 
mencement, and, like most fevers, is attended with a chill 
followed by a fever that is either high or low, according to 
the severity of the chill, but in the well-marked cases the 
temperature reaches a hundred and five, pulse rapid, tongue 
heavily coated. There is often nausea and vomiting, and 
sometimes diarrhoea. Bleeding from the nose is not an 
unusual symptom. There are few diseases more prone to 
delirium than erysipelas, especially when it affects the head 
and face. During the fever that follows the chill, the 
eruption appears, usually at the commencement of the 
fever, but this is not always the case, and until the eruption 
appears it is impossible to tell what the disease is. A 
doctor may visit a case in the evening and think he is deal- 



ERYSIPELAS. 1 37 

ing with a case of bilious fever, and give a diagnosis to that 
effect. By morning almost any person can name the dis- 
ease, because it has the characteristic eruption. The 
author, who had charge of two erysipelatous wards in Camp 
Douglas Hospital, Chicago, in 1865, treated several hundred 
cases. In almost all, the inflammation commenced about 
the head and face, there was great and rapid swelling of 
the skin, with burning, tingling pain, the swelling in almost 
all the cases being so great as to close the eyes. During 
an attack which would last a week or more, the eyes were 
probably closed, on the average, for forty-eight hours. 
There was more or less delirium, of a violent character, in 
most of the cases. It was controlled by the free use of 
water and bags of ice to the scalp. The ice-bags were 
applied for ten minutes at a time and then left off for twice 
that period, and so on until the delirium was subdued. In 
the milder form the water was used instead of ice-bags, a 
nurse sitting by the patient and fanning his head and face 
to hasten the evaporation of the water and reduce the tem- 
perature. The swelling of the skin, and also the extension 
of the inflammation, were combated with the tincture of 
iodine. Every part of the inflammation was painted two 
or three times in twenty-four hours by the strong tincture, 
the painting always reaching a little beyond the diseased 
skin. Great care was taken to prevent getting the drug 
in the eyes, and consequently the eyelids were not touched. 
The drug treatment consisted further of salts and cream of 
tartar in laxative doses, the aim being to get a good evacua- 
tion every day. With a view of overcoming the condition 
of the blood that was supposed to give rise to the disease, 
muriated tincture of iron in twenty-drop doses was given 
every three hours, so as to give a hundred drops or more 



138 ERYSIPELAS. 

during the day. No sedatives, no stimulants, and no tonics, 
except the iron, were given. Every case recovered. 

Termination. — Where the disease occurs in healthy 
subjects it is usually favorable. It may cause death from 
suffocation by closing the air passage of the larynx. As 
in all other grave affections, intemperate patients are most 
liable to succumb. 

Treatment. — In the mild cases of this disease, unat- 
tended by glandular enlargement and swelling of the 
skin, but little treatment of any kind is required. In 
such cases it is not necessary to paint the inflamed skin 
with iodine, as that drug is used mainly to stimulate ab- 
sorption and reduce the swelling. In the mild forms, or 
those in which the inflamed skin rises but little above the 
surrounding healthy skin, a solution of sugar of lead ap- 
plied to the surface with a small sponge will have a very 
soothing and cooling effect. Under its use the redness 
usually fades in a short time. The proper strength is a 
heaping teaspoonful to a pint of water. Great care must 
be taken to avoid getting it into the eyes. In the more 
severe cases, in which swelling of the skin and enlarge- 
ment of the glands about the throat are great, the strong 
tincture of iodine should be used upon every part of the 
affected skin, except the eyelids. It is best to apply it 
about every twelve hours. Should the swelling about the 
throat be of a character to threaten suffocation, hot poul- 
tices, changed every ten or fifteen minutes, should be 
applied. 

The disease can be greatly modified by the use. of a 
sedative to the heart's action if commenced early. If the 
pulse is decidedly strong and full, tincture of veratrum 
veride in two-drop doses every hour, for five or six hours, 



ERYSIPELAS. 1 39 

will do a great deal of good. There is often violent delir- 
ium during the first twenty-four hours, and as this is caused 
by the burning fever and brain congestion, any remedy 
reducing the force and frequency of the pulse must natu- 
rally reduce the fever, the congestion of the brain, and 
in doing so lessen the delirium. 

After the veratrum has been given for five or six hours 
in this way, it may cause sickness and vomiting. The 
nausea from veratrum is distressing, countenance pale, 
bedewed with a cold perspiration, pulse weak and flut- 
tering, the patient having all the symptoms of a fatal 
collapse. In such cases a tablespoonful of brandy will 
hasten a reaction, after which the disease runs an exceed- 
ingly mild course if it is not wholly aborted. It is not 
desirable to give the veratrum in such doses as to get the 
prostrating effects of the drug as above mentioned, but to 
watch the effect of it upon the pulse ; and when it com- 
mences to fall, stop the remedy at once. In two or three 
hours it may be commenced again, and sometimes it may 
be best to limit the dose to a drop every hour. Should 
the pulse not be full and bounding, with delirium and 
other symptoms less violent, it is better to use a milder 
sedative than the veratrum. Therefore, the tincture of 
aconite root may be given in drop doses for eight hours, 
and then left off two or three hours, to be resumed as 
before. The sooner the sedative treatment is begun after 
the fever is fairly established, and the nature of the disease 
recognized, the greater effect it will have in limiting the 
gravity of the affection. The same is true when veratrum 
is given instead of aconite. It is truthfully said that there 
is a time for all things, and there is certainly a time and a 
proper time, too, in which to give sedatives in inflamma- 



140 ERYSIPELAS. 

tory diseases, and that is as near the commencement of 
the attack as possible. The object is to arrest inflamma- 
tory development, and if the inflammation is allowed 
unlimited sway for forty-eight hours, a sedative of any 
kind can do but little, if any, good. In all forms of ery- 
sipelas, what is known as the iron treatment is the most 
efficacious. The muriated tincture of iron is the most 
popular form in which to give it, the dose being from 
twenty to thirty drops every three hours during the day- 
time. It should be largely diluted with water, and if the 
patient is rational, it is better to have it sucked through a 
straw or glass tube to avoid its effects upon the teeth. The 
treatment of erysipelas with this remedy has been so won- 
derfully favorable as to suggest the idea that its effects are 
not due wholly to the iron. It is very probable that the 
muriatic acid used in preparing the tincture has a favor- 
able effect in overcoming the condition of the blood to 
which erysipelas is mainly due. If the intense fever and 
delirium are not controlled by the sedative treatment, con- 
joined with the laxative effects of salts and cream of 
tartar, water may be applied freely to the head and face ; 
but the head must never be covered by a cloth of any 
kind. If the hair is kept thoroughly wet and the evapora- 
tion of the water hastened by the gentle but constant use 
of a fan, it will probably do more good in arresting the 
"fever and delirium than bags of ice applied to the head. 
There are many unpleasant things connected with the use 
of ice in this way, and one of them is, that the scalp is 
liable to be frozen, causing the hair to fall off and never 
return. In order to avoid this deplorable result, it is 
necessary to remove the bags of ice every five or ten 
minutes, and keep them off until heat returns to the 



GERMAN MEASLES. 141 

scalp. As reaction from the use of ice is very intense, 
the trouble is liable to be aggravated by leaving it off too 
long. It is therefore apparent that the use of ice in sub- 
duing inflammation affords an opportunity for two serious 
mistakes. For this reason water, as above advised, is 
much safer and better. The most violent forms of 
delirium are sometimes entirely subdued within ten 
minutes by holding the patient's head over a wash-tub 
with his face down, and pouring a dozen dippers of cold 
water all over it, keeping up a slow but constant stream 
for ten or fifteen minutes. 



GERMAN MEASLES. 

Other names: epidemic roseola; French measles; false 
measles. 

This affection is a self-limited disease, attended with 
slight fever, congested and watering eyes, sore throat and 
cough, while the glands about the neck are enlarged. The 
eruption, which is red and generally exists in patches of 
irregular size, appears on the first day. 

Cause. — It is due to infection, the exposure to the infec- 
tion before it breaks out covering a period of from one to 
three weeks. The length of time elapsing after a person 
is exposed to a disease until the attack commences is 
called the period of incubation. It literally means the 
hatching period. 

Symptoms. — It is an acute disease, and the attack is 
abrupt in its development, but the fever is mild, eyes 
suffused with tears, enlargement of the glands about the 
neck, attended with an inflamed condition of the throat, 
and pain on swallowing. The eruption generally appears 



142 VARICELLA. 

early in the disease, but sometimes it is delayed till the 
fourth day. The spots constituting the eruption are about 
the size of bird shot, rising a little above the level of the 
skin. Some of these spots run together, forming thick 
clusters of irregular size. The eruption appears on the 
upper part of the body first, and commences fading there 
about the time it begins to appear on the lower extremities. 

Termination. — Always favorable, as the disease runs its 
course in a week, leaving no after effects of any conse- 
quence. 

Treatment. — There is scarcely anything to be done in 
this affection. If there is severe itching of the skin, vase- 
line ointment, as recommended in scarlet fever and measles, 
will allay it. 

VARICELLA. 

Common name : chicken-pox. 

This is a mild, contagious, eruptive fever, the vesicles 
drying up and falling off within four or five days. 

Cause. — A specific poison, the disease being limited to 
childhood, because but few persons pass through that 
period without having it. 

Symptoms. — It commences with a moderate fever, fol- 
lowed by the eruption of vesicles that dry up rapidly and 
fall off within a week, leaving little dints or pits, very much 
like varioloid. 

Termination. — This is always favorable, as the affection 
is so trifling in its nature as to attract but little attention 
if it were not for the eruption. In some cases there is 
serious pitting, and it is very probable that persons dis- 
figured in this way are scrofulous subjects, and that the 
disease simply arouses an affection that had not previously 



APHTHOUS STOMATITIS. 1 43 

manifested itself, just as vaccination does under similar 
conditions. To avoid the pitting, use zinc ointment to the 
pimples, and cover the face, neck, and forehead with a black 
cloth, leaving holes for the eyes, mouth, and nostrils. 



APHTHOUS STOMATITIS. 

Other names : croupous stomatitis ; follicular stomati- 
tis ; vesicular stomatitis. 

This is an inflammation of the mucous lining of the 
mouth, including the covering of the entire tongue. It is 
characterized by vesicles appearing in small clusters in 
different parts of the mouth, these clusters multiplying in 
number and gradually spreading until they meet each 
other, thus involving the whole of the mouth and tongue. 
These vesicles finally rupture, leaving an ulcer correspond- 
ing to the size of the vesicle, and slowly heal. 

Causes. — It is a disease almost exclusively of childhood. 
It is due to deranged digestion, delay in teething, neglect 
to properly wash the child's mouth after nursing, and some 
of the eruptive fevers, especially measles. One of the most 
frequent and provoking causes is sour stomach, caused by a 
failure of the milk to digest. 

Symptoms. — It commences with a reddened and in- 
flamed condition of the mucous membrane of the mouth, 
soon to be followed by the appearance of whitish vesicles 
on the mucous covering of the lips and point of the tongue. 
As the disease develops, the vesicles, which exist in little 
clusters or patches, increase in number until every part of 
the mouth and tongue is covered with them. The mouth 
is so sore that the child cannot nurse. As soon as it 
catches the nipple and tries to nurse, it will let go with an 



144 APHTHOUS STOMATITIS. 

angry scream from pain. There is a constant flow of 
saliva from the mouth. In children two or three years 
old the mouth is so sore they cannot chew, and are com- 
pelled to live on liquid food. 

Termination. — Always favorable. 

Treatment. — As in all other cases the cause of the 
disease must be found and removed. The affection is 
usually attended with sour stomach, which can be con- 
trolled with bicarbonate of soda, given as follows : — 
Soda, a heaping teaspoonful, 
Water, a half pint. 
Mix ; dose a teaspoonful every hour. 

Where these vesicles run together so as to form, after 
rupturing, an ulcer of some size, it is best cured with 
carbolic acid, full strength, as follows : Clean the floor of 
the ulcer with a bit of absorbing cotton, then touch it with 
a drop of the acid so as to make the ulcer as white as 
milk. Several of them can be treated at one time, and 
they heal in a day or two. It will not do to treat very 
many of them at once, as there would be danger of poison- 
ing from the drug ; but carbolic acid has no equal in such 
cases, first, because it is painless, and, second, because it 
always cures. Nitrate of silver is cruelly painful, and 
should never be used as a caustic when carbolic acid will 
answer. If there is derangement of the bowels, small 
doses of calomel may be given as directed in the treat- 
ment of catarrhal stomatitis. 



THRUSH. 145 

THRUSH. 

Other names : white mouth ; parasitic stomatitis. 

This is an inflammation of the mucous membrane of the 
mouth, attended with the growth of a fungus or parasitic 
plant. There is usually derangement of the digestive 
organs. 

Causes. — The disease is largely due to carelessness and 
uncleanliness, and occurs in debilitated children. It is sel- 
dom seen after two years of age. 

Symptoms. — Great pain and tenderness, aggravated by 
chewing or nursing. There is great drooling, the lips are 
sore and swollen, and the breath has a fetid odor. There 
is generally diarrhoea attended with griping pains, the 
stools being green. 

Termination. — This is almost always favorable. 

Treatment. — Thorough cleanliness of the mouth is of 
the utmost importance, and the nipple must be thoroughly 
cleansed after nursing, and the mouth carefully rinsed. 
In this affection the stools are green, due to indigestion, 
and there is a great deal of griping pain which adds to the 
restless condition of the child. In this, as in all other 
affections of the mouth, in infancy and in childhood, when 
green stools are found, the following must be given : — 

Mercurius dulcis, the first decimal trituration, fifteen 
grains ; divide into five powders, and give one every hour 
until all are taken. A powder must always be placed in 
the mouth, dry, and then washed down with a swallow of 
water or milk. As the powders work off, the stools change 
from green to almost black, then gradually fade into brown, 
finally becoming yellow or natural, when the stomach and 
bowel derangement is conquered. As the mouth trouble 



146 GANGRENOUS STOMATITIS. 

is largely due to disorders of digestion, the powders given 
in this way favor a rapid recovery. 

The following is a very desirable wash for the mouth : 

Common borax, three drachms, 

Water, three ounces. 

Mix, and apply with a swab. 

GANGRENOUS STOMATITIS. 

Other names : water-cancer ; cancrum oris ; noma. 

This is a destructive, gangrenous ulceration of the mouth, 
in which most of the affected tissues are destroyed. 

Cause. — It is usually a disease of childhood, seldom 
appearing in adults, and is due to a parasite. 

Symptoms. — The disease may develop in connection 
with ulcerative stomatitis, or it may start as a sloughing 
ulcer upon the gum or mucous membrane of the mouth, 
when all the other mucous tissue is seemingly in a healthy 
condition. There is great swelling of the cheek, the skin 
becoming glossy, the inflammation spreading, usually so 
as to involve entirely one side of the face. 

The pulse is rapid but weak, fever high, debility great, 
and the case is characterized by a terribly disagreeable 
odor. Death usually occurs in a week or ten days. 

Termination. — This is almost always unfavorable, as it 
is one of the most malignant diseases that afflict children. 

Treatment. — There is practically nothing to be done in 
these cases, except to make the patients as comfortable as 
possible until death ends the suffering. 



ULCERATIVE STOMATITIS. 1 47 

ULCERATIVE STOMATITIS. 

Another name : diphtheritic stomatitis. 

This is an inflammation of the mucous membrane of the 
mouth, diphtheritic in character, attended with extensive 
ulcerations. It generally begins on the edges of the lower 
gum, and soon affects the lips and whole interior of the 
mouth. It is almost wholly a disease of childhood, and 
is closely connected with poverty, indolence, and unclean- 
liness. 

Symptoms. — It commences with an inflamed and swol- 
len condition of the gums, both chewing and swallowing 
causing great pain, and the patient is compelled to live on 
liquid food. The mouth is intensely feverish, and hot 
saliva, often mixed with blood, drips from the mouth ; the 
glands below the jaw are enlarged and very sore. 

Termination. — This is quite favorable so far as life is 
concerned, but the destruction of the gums is considerable, 
and sometimes part of the teeth are lost. 

Treatment. — The cause of the disease should be found 
and removed. Absolute cleanliness must be observed 
from first to last. 

Chlorate of potash, given in three-grain doses every two 
hours, has a positive curative value, its prompt action 
often winning for it the reputation of a specific. In this 
affection there is a very low state of vitality with a dis- 
position of the ulcers to spread, and to touch them 
with carbolic acid, which lowers the vitality of the part 
for many hours, might do a great deal more harm than 
good by increasing the disposition to spread ; therefore, 
a very stimulating application, such as nitrate of silver, ten 
grains to the ounce of water, may be necessary. Should 



148 GLOSSITIS. 

irritation of the stomach and bowels exist in this affection, 
it may be treated in the same way as in catarrhal stomatitis, 
which please see. 

GLOSSITIS. 

This is an inflammation of the entire structure of the 
tongue, in which swelling is great, mastication and swallow- 
ing painful, and speaking difficult or impossible. It may 
be either acute or chronic. The acute form is generally 
caused by an injury, such as hot water, an irritating drug, 
or the sting of an insect. 

In the chronic form the inflammation is generally limited 
in extent, may be caused by constant irritation from the 
teeth, and also from the use of a tobacco pipe. Smoking 
is by far the most frequent cause of chronic inflammation 
of the tongue, the inflamed and reddened part usually 
appearing at or near the point. When once, established, 
it is almost impossible to cure it until the smoking is left 
off. While the nicotin of the tobacco has much to do 
in causing the inflammation, it is not the only source of 
the trouble, as the heat of the smoke, especially when 
a cigarette is used, is very irritating. To overcome the 
trouble from heat, it is often found necessary to use a pipe- 
stem two feet long. 

Symptoms. — Acute inflammation of the tongue develops 
suddenly, is attended with fever, pain, anxiety,* and great 
swelling of that important organ. There is always an 
unusual flow of saliva, and a burning sensation in the mouth. 
Chewing and swallowing are difficult. The power of speech 
is almost lost, and there is threatened suffocation. There is 
usually enlargement of the glands at the angles of the jaw. 

Termination. — This is not always favorable, as there is 



GLOSSITIS. 149 

more or less danger of death from suffocation. Chronic 
inflammation of the tongue, after it has existed for many 
months, is very difficult to cure, and in the majority of 
cases is not favorably affected by any treatment, except 
when due to smoking, recovery may occur when the habit 
is abandoned. 

Treatment. — This should commence as soon as possible 
after the disease is developed and recognized, and the best 
possible remedy to break the force of the inflammatory 
action and lessen the dangers that are liable to arise from 
suffocation, is the tincture of veratrum veride in three-drop 
doses every hour for six or eight hours. It should be given 
in a tablespoonful of water. By the time five or six doses 
are taken in this way the pulse may fall rapidly, attended 
with extreme nausea and vomiting, the countenance very 
pale and wet with a profusion of cold perspiration. In 
a case with such marked drug action as the above, the 
pulse is liable to be feeble and fluttering, and this, conjoined 
with the other symptoms, suggests the idea of a fatal col- 
lapse. When reaction occurs, which may be hastened with 
a tablespoonful of brandy, the pulse gradually increases 
in volume, heat and color are restored to the features, the 
nausea and vomiting stopped, and the patient is better in 
every way, the inflammatory action being almost subdued. 
Where this treatment has been followed so as to get such 
decided drug action as this, the case rarely needs further 
treatment. The prostrating effects of the drug, however, 
are frightful to those who have had no experience with 
it, but the cases of death are a hundred times more nu- 
merous from the less violent sedative, aconite, than from 
veratrum, as the latter gives warning of its own specific 
action through vomiting. Aconite does not. 



150 CATARRHAL STOMATITIS. 

CATARRHAL STOMATITIS. 

Other names : simple stomatitis ; catarrh of the mouth. 

This is an acute inflammation affecting the mucous 
membrane of the mouth and tongue and sometimes the 
throat. It may be limited to a part of the mouth, but in bad 
cases it involves the whole mucous surface. Infants at the 
breast are most liable to the affection. 

Causes. — It most frequently arises from inflammation of 
the mouth caused by teething and disorders of the stom- 
ach. All the eruptive fevers, such as measles, scarlet fever, 
and smallpox, have a tendency to produce the affection. 

Symptoms. — Stomatitis commences with the usual 
signs of inflammation, such as heat, pain, and redness, and 
may affect the entire mouth or only a part of it. The 
mouth is usually so sore that infants cannot nurse, render- 
ing it necessary to feed them with a spoon. They are 
intensely fretful and hard to take care of. 

Termination. — Patients almost always recover from the 
acute form of the disease. In chronic cases they are gen- 
erally adults in whom the disease has been developed by 
alcohol or tobacco, and no treatment is available in such 
cases until the tobacco habit or the whiskey is abandoned. 

Treatment. — That which is most important in this, as in 
all other affections, is to remove the exciting cause. If it 
is due to derangement of the stomach, this may be some- 
what easily effected; but if from difficulty and delay in 
teething, it may require weeks of time to remove the cause, 
as the teething process cannot be hastened, and any 
attempt to do so by lancing the gums is injurious. When 
a tooth is almost ready to come through the gum, so its 
sharp edges can be felt by the finger, mothers sometimes 



CHRONIC BRONCHITIS. 151 

bring it through by rubbing the gum with the edge of a 
thimble or the ringer nail. This is all right ; but when the 
tooth is covered by enough tissue to require the use of a 
lance, the incision in the gum will close by healing, the 
scar will be harder than the natural gum, and it will be 
that much harder for the tooth to get through when the 
proper time comes. 

The following mouth wash will probably give the best 
results in allaying the irritation : 

Borax, two drachms, 
Water, three ounces. 

Mix, and use as a mouth wash three times per day. 



CHRONIC BRONCHITIS. 

Other names : winter cough ; secondary bronchitis. 

This is a chronic inflammation of the membranes lining 
the large and middle-sized tubes of the lungs. It is 
attended with cough and copious expectorations. 

Causes. — The main causes are exposures to cold, or liv- 
ing in a wet, disagreeable locality or climate. It is also 
caused by the inhalation of irritants, such as marble dust, 
and often afflicts stone-cutters. The secondary form is 
mostly due to inflammatory affections of the lungs. 

Symptoms. — The principal symptoms of the disease are 
cough and expectoration. The cough is more or less peri- 
odic, disappearing at times and then reappearing, and thus 
continuing more or less through life. It is more severe at 
night, the expectoration being greatest in the morning. 
As the lungs and stomach are supplied by the same nerves, 
a sympathetic action between the two organs manifests 



152 CHRONIC BRONCHITIS. 

itself by a loss of appetite, impaired digestion, and the 
general symptoms of dyspepsia. 

Termination. — Chronic bronchitis when not complicated 
by other diseases is rarely a fatal affection. 

Treatment — Patients suffering with this affection may 
find great relief by adopting and carefully following proper 
hygienic measures. The most important of these, except- 
ing a change of climate, is to wear woollen underclothing, 
year in and year out, always keeping the feet warm and 
dry. There is no one factor in the treatment of the 
disease so important as a change from a low, cold, wet cli- 
mate to one that is high, dry, and moderately warm. Per- 
sons going from the low altitudes of New England, where 
the air is damp and cold, to live on the dry plains of New 
Mexico, or to the best of all climates, Southern California, 
are not only relieved of their sufferings from chronic bron- 
chitis, but in almost all cases get entirely well. Complete 
recovery often occurs when the changes of climate are 
much less radical, as when patients go from the eastern 
coast to central Kansas where the altitude is only about 
twelve hundred feet above the sea level. So far as a per- 
manent cure is concerned there is nothing but a decided 
change of climate that affords much, if any, hope, but there 
is one drug, if properly given and for a sufficient length of 
time, that favorably affects most cases of chronic bronchi- 
tis. It is iodide of potassium and should be given as fol- 
lows : — 

Iodide of potassium, two and a half drachms, 

Compound syrup of stillingia, one pint. 

Mix ; dose a half tablespoonful three times a day. 

This mixture may aggravate the symptoms for a few 
days by causing a flow of mucus from the nose, but the 



INFLUENZA. 1 53 

system soon gets used to the drug, when a gradual 
improvement follows, the cough becoming much less 
troublesome. The treatment should be followed for 
several months. Where it is given in chronic bronchitis 
attended with asthma, the paroxysms of the latter are 
usually much less frequent and less severe. The syrup of 
stillingia in this prescription is not used merely as a con- 
venient vehicle for iodide of potassium, but it has a curative 
effect, scarcely second to the iodide itself; and those who 
have always given iodide of potassium in simple syrup or 
some other form instead of being combined with stillingia, 
have failed to appreciate one of the most valuable altera- 
tives we have. 

INFLUENZA. 

Other names : La Grippe ; " grip ; " contagious catarrh. 
This is an acute, infectious fever, somewhat contagious. 
There is almost always bronchitis, derangement of the 
digestive functions, and marked disturbance of the nervous 
system. There is usually great debility with a tendency 
to melancholy. 

Cause. — The disease is due to bacillus, another term 
for a disease germ that floats in the atmosphere. It is 
said that one attack of the disease predisposes to another. 

Symptoms. — The disease ranges in severity from the 
mildest possible form to one of the gravest character. In 
those cases that are well marked, the disease generally 
commences with a chill or a chilly feeling, followed by 
fever. The pulse is quick, shooting pains about the eyes, 
pains in the muscles and also about the joints, suggesting 
the idea of rheumatism. There is chilliness along the 



1 54 INFLUENZA. 

spine, pain in the throat, hoarseness, as if from a severe 
cold, deafness, discharge from the nose, frequent sneezing, 
as in hay fever, eyes red and watery, and usually a severe 
cough. The attacks are sometimes attended with distress 
in the stomach, nausea, vomiting, and diarrhoea. The 
fever generally begins to subside in from four to seven 
days, and a slow convalescence is established. Relapses 
often occur. The most frequent and fatal complications 
are those of pneumonia. The mild attacks are liable to 
be mistaken for a "bad cold." 

Termination. — Almost always favorable, as the fatal 
cases are less than one in a hundred. 

Treatment. — The medical profession knows no remedy 
that can be ranked as a specific in this disease. The 
most rational course to pursue is to meet the symptoms 
with the best known remedy as they occur. Everything 
that has a tendency to exhaust the vitality, or depress the 
nervous system, or unduly excite the respiratory functions 
and heart's action, should be carefully avoided. 

Patients should be kept comfortably warm, and as a 
general thing it is safest for them to keep their bed. 

For the guidance of every one who may be afflicted with 
this disease, it is well to state this : The great majority of 
fatal cases are rendered so by exposure to cold and the 
hardships of labor or business after the disease has set in. 
One peculiarity of this affection is, that violent physical 
exertion during the attack, even though it may be mild, is 
very apt to develop pneumonia, the most dangerous com- 
plication. 

The most annoying symptoms of this trouble, such as 
pains in the muscles and joints, cough, and acute nasal 
catarrh, are relieved by Dover's powder in ten-grain doses 



INFLUENZA. 1 55 

four or five times in twenty-four hours; in mild cases, two 
or three powders will be sufficient. 

It is a self-limited disease, running its course in from 
five to twelve days, and there is but little to be done except 
keeping the patient either in bed or in a warm, comfortable 
room, and giving such remedies as are best calculated to 
secure rest and comfort. 

If there is sickness of the stomach with a tendency to 
vomiting, it can be promptly controlled by giving a half 
grain of the extract of ignatia before each meal. The 
headache complications are also controlled by the same 
remedy. 

AFTER EFFECTS. 

One of the most terribly unfortunate terminations of this 
disease is the state of mental aberration, or deranged mind 
that often follows it. Such patients are liable to be greatly 
depressed and to live in a chronic state of melancholy with 
great tendency to suicide. They are also in a somewhat 
childish condition, with an inclination to weep on the slight- 
est provocation. Whether these symptoms are due to 
indigestion or not, the best remedy is the extract of igna- 
tia, ranging in dose from one-half to a full grain, accord- 
ing to the size of the patient, persons weighing over two 
hundred pounds requiring a full grain. 

One pill is to be given before each meal and should be 
continued for several weeks; meanwhile the patient should 
not be left alone, as many have been known to slip off to 
the barn and hang themselves, or suicide in some other 
way. 



156 PLEURISY. 



PLEURISY. 



Other names : stitch in the side ; pleuritis. 

This is an inflammation of the pleura, which is a mem- 
brane covering the lungs or lining the cavity of the thorax. 
The membrane covering the lungs is called the pleura 
pulmonalis. The membrane lining the chest is called 
pleura costalis. They are both sleek, glossy membranes, 
and come in contact with each other in breathing. Dur- 
ing inflammation of the lungs there may be more or less 
pleurisy, and in that case it is usually inflammation of the 
membrane covering the lungs. Where the disease comes 
on independently of inflammation of the adjacent organs, 
it is very liable to affect both membranes. 

Causes. — It is usually due to exposures to cold or to 
injuries of the chest. Consumption frequently causes pleu- 
risy, but in such cases it is limited to a small part of the 
membrane covering the lungs, and is never what is termed 
general pleurisy. 

Symptoms. — The disease in its acute form commences 
as most inflammatory affections do, with a chill, followed 
by a sharp pain in the side or near the nipple, which is 
always increased by breathing or coughing. The breath- 
ing is rapid, running from thirty to forty per minute, 
attended with a dry cough, fever, and frequent pulse. 
Soon water is poured out on the surface of the inflamed 
membrane, the fluid accumulating between the two mem- 
branes, the one covering the lung and the other lining the 
walls of the chest. This fluid presses upon the lungs and 
interferes with breathing, the difficulty being in proportion 
to the amount of the existing fluid. It often causes a feel- 
ing of threatened suffocation, and the patient almost always 



PLEURISY. 157 

lies on the affected side. There are two reasons for doin 



b 



so. The first is to keep the muscles of that side that are 
concerned in breathing, in a state of perfect rest so as to 
prevent pain by the inflamed membranes rubbing against 
each other. The second is to give the sound lung every 
opportunity to carry on the functions of respiration, instead 
of being compressed by the weight of the body and dimin- 
ished in its breathing capacity. 

Cases of pleurisy that are more or less chronic come on 
slowly, after exposure to cold or other exciting causes. 
Such cases are affected by shortness of breath, aggravated 
on slight exertion, have fever and night-sweats, a dry cough, 
the pulse being small, frequent, and rather weak. There 
may be but little, if any, pain in the side. 

Termination. — Pleurisy that comes on independent of 
any other affection is generally favorable, running its course 
and ending in recovery within a few weeks. If it exists as 
a result of pneumonia or consumption, it ceases to be a 
simple disease, and the danger to life is largely due to the 
cause producing it. 

When it occurs on both sides at the same time it is called 
double pleurisy, and is exceedingly unfavorable. 

Treatment. — In all cases of acute pleurisy in which the 
inflammatory symptoms, such as severe pain, full, frequent, 
and bounding pulse are present, a sedative to the heart's 
action should be given every hour as follows : — 
Tincture veratrum veride, one drachm, 
Water, four ounces. 

Mix, and give a teaspoonful every hour for eight hours, 
then leave it off for three hours, after which give it every 
two hours for twelve hours longer. If at any time while 
this drug is being given sickness and vomiting should occur, 



158 PLEURISY. 

it must be left off at once, and a tablespoonful of whiskey in 
an equal amount of sweetened water given. When vomit- 
ing occurs from the remedy given in this way, it almost 
always reduces the force and frequency of the pulse, brings 
the temperature down greatly, and relieves pain and other 
distressing symptoms. When this occurs, the pleurisy or 
inflammatory process, whatever it may be, is completely 
aborted, and rapid recovery follows. Unfortunately, how- 
ever, the cases of pleurisy that are sufficiently acute and 
violent to call for this powerful sedative, are comparatively 
few. 

For this reason, milder forms of treatment have to be 
employed in most cases. While there is nothing so com- 
pletely abortive as the veratrum veride when it is perfectly 
adapted to the case, there are other remedies calculated to 
modify the disease and greatly shorten its course, and one 
of the very best is salicylate of soda, given as follows : — 
Salicylate of soda, two drachms, 
Water, four ounces. 

Mix, and give a teaspoonful every hour for eight or ten 
hours, after which give it every two hours. If this is com- 
menced in the early stage of pleurisy, and the patient cov- 
ered up warmly in bed, profuse perspiration will soon follow, 
and with it a subsidence of the pain, fever, and other dis- 
agreeable symptoms. It is claimed by the best authorities 
that pleurisy is often broken up by this drug, if timely and 
properly given, and that it is also valuable in the stage of 
affusion, or during the collection of water in the cavity of 
the chest. After water has accumulated in the thoracic 
cavity it greatly embarrasses the breathing process, and 
should be gotten rid of as soon as possible ; and the follow- 
ing treatment hastens its absorption : Give, about an hour 



ACUTE TONSILITIS. 159 

before breakfast, two heaping tablespoonf uls of Epsom salts 
dissolved in two or three ounces of water. Continue this 
for two or three mornings and there will be four or five 
stools each day, consisting almost entirely of water, and in 
that way the system is in a great measure drained of the 
watery portion of the blood, and the fluid in the cavity of 
the chest naturally passes back into the circulation. But 
little water should be given to the patient during this 
treatment. 

In the chronic form of pleurisy, absorption of the fluid 
should be stimulated by iodide potassium in ten-grain doses, 
three times per day, in a gill of water. In all cases of 
pleurisy it is best to control the pain with the sulphate of 
morphine, given in quarter-grain doses every three or four 
hours, as the case seems to require. 

ACUTE TONSILITIS. 

The common name is quinsy. 

This is an acute inflammation involving the structure or 
substance of one or both tonsils, and is attended with fever 
and pain in the throat which is greatly increased by swal- 
lowing. In the majority of cases one or both tonsils sup- 
purate, and either break or have to be lanced. 

Symptoms. — The disease commences suddenly with a 
chill, followed by a fever, the pulse being full and strong, 
characteristic of inflammation. There is headache, great 
thirst, with swelling at the angle of the jaw, severe pain 
which is always increased by swallowing. There is a 
feeling of suffocation caused by the general swelling about 
the throat, but more especially from enlarged tonsils. When 
suppuration of one of the tonsils is taking place, all the 



l6o ACUTE TONSILITIS. 

distressing symptoms are increased, and to these are added 
a new one, that of painful throbbing in the affected tonsil. 
This gets worse and worse, the pain and throbbing in- 
creases, the breathing becomes more and more embarrassed, 
and the countenance takes on an anxious expression. Fi- 
nally in a violent effort to cough or get rid of offending mucus 
in the throat the abscess of the tonsil breaks, the matter is 
discharged by the mouth, and immediate relief follows. 

Termination. — This is almost always favorable, except 
in children. In the little patients it sometimes proves 
fatal by obstructing the air passage in the throat. 

Treatment. — In all inflammatory affections commen- 
cing suddenly with a chill and followed by a high fever 
and a strong, full, and frequent pulse, tincture of veratrum 
veride in two-drop doses every hour, should be given to 
an adult for about six hours. Acute tonsiiitis is of this 
character, and the system should be brought under the in- 
fluence of the drug as soon as possible without running 
the risk of over-dosing. Where the veratrum is given 
every hour in this way the pulse must be watched, and as 
soon as it commences to fall, the remedy should be left off 
for a couple of hours. The object of the veratrum is to 
so control the heart's action as to lessen the amount of 
blood sent to the affected part, and in doing this to reduce 
the swelling, the fever, the inflammation, greatly relieve 
the pain, and prevent abscess of the tonsils. There is 
nothing so capable of bringing about these favorable re- 
sults as this drug. Unlike the tincture of aconite, if it is 
given in too large doses, or continued for too long a time, 
or in small doses too often repeated, it causes vomiting, in 
which the drug is thrown up. The sickness in such cases 
warrants the doctor or nurse to discontinue the remedy for 



WHOOPING COUGH. l6l 

a few hours. A tablespoonful of whiskey will check the 
sickness and hasten a reaction. Aconite gives no warn- 
ing of its dangerous effects upon the system, and for that 
reason is a dangerous remedy. 

During the whole course of this disease the bowels may 
be kept open by a mixture of Epsom salts and cream of 
tartar, equal parts, given in heaping teaspoonful doses two 
or three times per day in a half glass of water. It is well 
to stimulate the kidneys by a teaspoonful of sweet spirits 
of nitre in a gill of water every three hours. 

WHOOPING COUGH. 

Other names : pertussis ; hooping cough. 

This is a catarrhal affection of the bronchial tubes of 
the lungs, manifesting itself by convulsive coughs coming 
on in paroxysms, and characterized by a loud, familiar 
whoop as the air is drawn into the lungs. 

It is a disease of childhood, because a person seldom 
fails to contract the affection in early life. One attack 
usually prevents another. It is due to a poison, the char- 
acter of which is unknown, that acts upon the nervous 
system. 

Symptoms. — It has three stages. The first is the ca- 
tarrhal stage in which the membranes of the nose, the 
larynx and bronchial tubes are affected, and this stage is 
attended with a loose cough, lasting from one to two weeks. 

The second stage is the whooping or spasmodic stage, 
in which the cough comes on in paroxysms, and is exceed- 
ingly rapid so as to almost exhaust the child, and when 
the breath is about given out, the effort of the child to get 
another full breath is accompanied with a crowing whoop. 



1 62 WHOOPING COUGH. 

There are usually about three spells of coughing in each 
paroxysm, the last one generally ending with a discharge 
of mucus and sometimes vomiting. Bleeding of the nose 
sometimes occurs during this stage. 

The third or closing stage : During this stage the par- 
oxysms become less frequent or milder in character and 
shorter in duration, the expectoration is easier, and the 
patient much more comfortable. The duration of this 
stage is from one to two weeks, ending in recovery. 

Termination. — This is almost always favorable, except 
in very young infants or when associated with other dis- 
eases. 

Treatment. — It is a self-limited disease, and it is doubt- 
ful if its course can be shortened by remedies. As a gen- 
eral thing, simple whooping cough does not require any 
drug treatment. The little patient should be kept in 
rooms that are comfortably warm and not exposed to 
draughts of cold air, and the clothing should be warm. 
When the cough is severe, the spells may be modified in 
severity and lessened in frequency by the following : 
Brown mixture, six ounces. Shake, and give from a half 
to a teaspoonful and a half, according to the age of the 
child. The dose may be repeated every four hours if 
necessary. When this is given at bedtime and another 
dose after midnight, the paroxysms after midnight will be 
less frequent and less severe. 



ASTHMA. 163 

ASTHMA. 

Other names : spasmodic asthma ; bronchial asthma. 

This is a spasmodic contraction of the muscles surround- 
ing the smaller tubes of the lungs, and is paroxysmal in 
character. It is almost always attended with chronic 
bronchitis, and in the majority of cases the frequency 
and severity of the asthmatic attacks are in proportion 
to the existing bronchitis. 

The spasmodic attacks of asthma may last for only a 
few hours, or they may last for weeks. In some patients 
they are always short, in others always long. 

Causes. — Asthma is undoubtedly a nervous affection, 
and is due to a condition of the nervous system that 
affects the breathing functions. It is essentially a he- 
reditary disease, that is, the tendency to the disease is 
inherited. 

Attacks of asthma are frequently brought on by dis- 
agreeable odors, such as musty feathers or mattresses. 
Dust of any kind, but more especially that of irritating 
drugs, often causes a violent attack. 

The most distressing paroxysms often arise from a re- 
flex or sympathetic condition in which the stomach is the 
seat of the trouble, as when that organ is gorged with a 
heavy, meat supper, or food that is difficult to digest. 

In such cases the attack may be cut short by vomiting. 

Symptoms. — When asthma first sets in, the seizure may 
be sudden, but after the disease has once fixed itself upon 
an individual, the attacks are preceded by warning symp- 
toms which are usually those of a common cold. Acute 
indigestion is often one of the premonitory symptoms. 

The paroxysms may come on at any time, but like other 



1 64 ASTHMA. 

nervous disorders frequently break out in the night. The 
first symptom of the attack is an intense and anxious de- 
sire for air. The breathing is attended with loud wheezing, 
the face is either flushed or takes on a dusky appearance 
due to a want of breath. The labored breathing sometimes 
brings on profuse perspiration, and the symptoms for a 
time are so distressing as to threaten life from suffocation. 

Sooner or later the respiration becomes easier, the tubes 
of the lungs ceasing their spasmodic contraction, and the 
dusky appearance of the face changes to normal, and the 
paroxysm is over. Sometimes asthma consists of a series 
of attacks and remissions, lasting for many days or even 
weeks, during which the patient is unable to attend to busi- 
ness of any kind. 

Termination. — Simple asthma is never fatal. 

Treatment. — The first and most important thing to be 
done is to relieve the distressing paroxysm, and the second 
to commence such a course of treatment as to prevent, if 
possible, its recurrence. If the treatment fails in prevent- 
ing other paroxysms it may reduce them in number and 
severity. To relieve the paroxysm a full dose of opium in 
some form is the most effective. A quarter of a grain of 
morphine, if given to a patient not long accustomed to its 
use, may give prompt relief, but if the drug has been used 
a great many times it may take twice that amount or a 
full half-grain. There are two serious objections to mor- 
phine, or opium in any form. The first is, that the dose 
must be gradually increased until it becomes enormous in 
order to be effective. This necessarily develops the opium 
habit. The second objection is, that it suppresses the se- 
cretion of all the organs, and causes disorders of digestion. 
Therefore, it is a poor remedy in a never-ending disease 



ASTHMA. 165 

like asthma. It is much better to rely upon inhaling the 
smoke from burning stramonium leaves, or nitre-paper, or 
both. 

The disease is one of the most distressing that afflict 
mankind, and the effects of any drug used to overcome 
the paroxysm will wear out sooner or later, and for this 
reason a great deal of time is spent by asthmatic patients in 
hunting for a new remedy to relieve their sufferings. The 
disease is usually considered incurable, and this is true, 
if the patient is compelled to live in a climate and locality 
where it developed. As a great many cases are attended 
with chronic bronchitis upon which the severe attacks of 
asthma mainly depend, a systematic treatment should be 
adopted with a view of curing this affection. The follow- 
ing is the best : 

Iodide potassium, three drachms, 

Compound syrup of stillingia, one pint. 

Mix; dose a half tablespoonful three times per day. 
This remedy soon produces a flow of mucus from the 
nose with other symptoms of a severe cold. It affects in 
the same way the mucous membranes of the bronchial 
tubes of the lungs, and gradually cures or greatly relieves 
the bronchitis, and just in proportion as it is relieved the 
asthma is modified. The pleasantest thing that can be 
said of asthma, obstinate and stubborn as it always is, is 
this : Proper climatic changes will almost always cure it, or 
so wonderfully modify it, that the attacks scarcely amount 
to anything. The author can speak from abundant expe- 
rience on this subject, and knows that the altitude of 
Denver, Col., affords in most patients an immunity from 
asthmatic attacks. There are others, however, who are 
not greatly benefited by living in Denver. They need a 



1 66 SPITTING OF BLOOD. 

drier atmosphere than that locality, and may find com- 
plete relief in Los Angeles, and other parts of Southern 
California. Others may fail to get relief in California, and 
get permanent freedom from it on the high and dry moun- 
tain ranges of the West. 

It sometimes happens that climatic influences, though 
almost absolutely curative to commence with, lose their 
effect in time, but this rarely occurs except after the lapse 
of many years. 

SPITTING OF BLOOD. 

Other names : haemoptysis ; . pulmonary hemorrhage. 

This consists of an expectoration of blood following or 
accompanying the act of coughing, the blood usually being 
bright red. 

Causes. — It is almost always due to pulmonary con- 
sumption in which small arteries have been severed by 
the destructive process of tubercular softening. It may 
also be caused by violent muscular action in which small 
blood-vessels of the bronchial tubes are ruptured. 

Symptoms. — It occurs suddenly as a general thing. 
Sometimes it has no warning symptom whatever, while at 
others it is preceded by a slight pain in the throat. The 
quantity of blood may be small or it may be a pint or more. 
Sometimes it is so great as to end fatally in an hour. As 
a general thing the attacks are much less severe and sub- 
side for several hours at a time, to come on the following 
night or day. 

Termination. — Spitting of blood in itself is not neces- 
sarily dangerous, although it weakens the patient and has 
a discouraging effect upon his mind, as it is usually hailed 
as an unmistakable sign of consumption. 



MUMPS. 167 

Treatment. — The patient should be kept in a state of 
perfect rest in bed, as the least movement of the body ag- 
gravates the hemorrhage. 

The author has always been able to stop the spitting of 
blood by giving a teaspoonful of the fluid extract of ergot, 
repeating the dose in twenty minutes if necessary. The 
second or third dose always stops the hemorrhage if the 
first does not. 

MUMPS. 

Another name : parotiditis. 

This is an inflammatory disease involving the parotid 
glands at the angles of both jaws, and also other salivary 
glands, and adjacent parts. The affection is much inclined 
to move to other parts of the body, affecting the mammary 
glands or breasts of females and the testicles of males. It 
is characterized by swelling, pain, and functional disorder 
of the parts affected, and is infectious, that is, it is 
"catching." 

Cause. — It is due to a specific poison, and one attack 
almost always affords an immunity from other attacks. 

Symptoms. — It comes on quite suddenly, often with 
a slight chill, followed by considerable fever, frequent 
pulse, headache, and dry skin. Within twenty-four hours 
it is difficult for the patient to open his mouth, owing to 
the swelling and soreness at the angle of the jaw or at the 
affected side, if only one side is involved. The disease 
runs its course, as a general thing, within eight or nine 
days, and where both sides are involved simultaneously it 
will run its course in about a week. 

The affection is liable to be set up in the breasts, ovaries, 
or testicles, any time during its usual course. If the fever 



1 68 MUMPS. 

continues after the glandular swelling subsides, the disease 
is very liable to migrate to the other parts. 

Termination. — Uncomplicated mumps almost always 
end favorably. But while the affection does not endanger 
life it is liable to impair, or even destroy, the functions of 
the ovaries and testicles. 

Treatment. — The disease is self-limited, running its 
course in about a week, and with proper care, recovery 
ought to be perfect. 

The author has treated hundreds of cases, has always 
kept the boys in bed until the subsidence of the glandular 
swelling, and kept them in their room for some time after- 
wards. Children of either sex should not be exposed to 
draughts of cold air, nor be allowed to sit in cold rooms 
during the disease. A state of perfect quiet for each a^d 
every patient should be maintained, as any exercise, such 
as romping and playing, increases the heart's action and 
tends to the development of the disease in the sexual 
organs. If the glands about the jaw continue to be 'en- 
larged after the disease has had proper time to run its 
course, they should be painted with the tincture of iodine, 
twice in twenty-four hours. In addition to this give the 
following : — 

Iodide of potassium, two drachms, 
Simple syrup, a half pint. 

Dose, teaspoonful three times a day. If the child is 
very young, half of the above dose will be sufficient. If 
the testicles are inflamed and swollen, hot flaxseed poul- 
tices, changed every fifteen minutes, should be used. It is 
twenty times easier to keep children quiet in bed, and in 
that way avoid inflammation of the testicles, than it is to 
control it after it is established. 



MEMBRANOUS CROUP. 1 69 

MEMBRANOUS CROUP. 

Other names : true croup ; croupous laryngitis. 

This is an acute inflammation of the mucous membrane 
of the larnyx in which a false membrane is gradually de- 
posited upon the true membranes. 

Cause. — It is a disease of childhood and most common 
in strong and vigorous boys. 

Symptoms. — Membranous croup may develop suddenly, 
being ushered in by an attack of spasmodic croup, or it may 
come on as an acute inflammation of the larnyx, attended 
with fever, thirst, dry cough, and hoarseness or loss of 
voice. Difficulty of breathing soon follows in which the 
child is unable to lie down. As this increases, each inspi- 
ration is attended with a shrill or almost whistling sound. 
As the disease continues to develop, the air passage is 
narrowed by encroachments of the membrane from all sides, 
and fatal suffocation is threatened. The skin gradually takes 
on a bluish appearance caused by a deficiency of air in the 
lungs, and death seems imminent ; but sometimes when all 
hopes appear desperate the spasm is suddenly relaxed, the 
air rushes into the chest, the breathing is easier, and the 
child drops into a short sleep. 

But these attacks of suffocation continue to return at 
short intervals, or there may be portions of the false mem- 
brane discharged by coughing, affording longer intervals 
of quiet repose. 

In favorable cases the paroxysms gradually become less 
severe and less frequent, the bluish cast of the skin fades, 
the difficulty of breathing is less, the cough gets looser, the 
voice becomes more natural, and the fever diminishes or 
ceases altogether. 



170 MEMBRANOUS CROUP. 

If the case is destined to end fatally, all the violent and 
distressing symptoms are aggravated, the paroxysms are 
more frequent, expectoration ceases, the voice is lost, diffi- 
culty of breathing increases, and the blue condition of the 
skin takes on a deeper hue. The child becomes drowsy 
and stupid from blood poisoning, a cold, clammy sweat 
comes on, and the patient dies for want of breath. 

Treatment. — The indications are first, to commence treat- 
ment as soon as the character of the disease is suspected, 
with a view of arresting the inflammation and preventing 
the formation of the false membrane, as it is a great deal 
easier and safer to stop the development of the croup mem- 
brane, than to secure its detachment and expulsion after it 
is fully formed. As the disease is essentially an inflamma- 
tion of the natural membrane of the larnyx, and the false 
membrane is simply a product, and often a fatal one too, 
there is nothing more obvious than this : Any remedy that 
will stop the inflammation will prevent the false membrane 
from forming. The author is positive, from years and years 
of experience, that tartar emetic given in small doses, after 
vomiting is once established, so as to keep the child under 
the influence of the drug for eight or ten hours, will so re- 
duce the inflammation as to prevent the false membrane. 
The extent to which it is proposed to keep the patient 
under the influence of the drug is this : It is to be given 
every fifteen minutes until vomiting occurs. After this 
the sickness of the stomach, followed by vomiting, will 
occur every half hour for two or three hours, and mean- 
while there will be watery discharges from the bowels, prob- 
ably. As soon as the sickness of the stomach subsides, 
about half of the first dose of the drug should be given, and 
in this way sickness of the stomach, attended with more or 



MEMBRANOUS CROUP. 171 

less vomiting every hour, should be maintained for eight or 
ten hours. As soon as the child vomits, it drops back into 
a refreshing sleep and so continues until the sickness and 
vomiting come on again. In such cases the hot skin and 
flushed or bluish countenance are absent, the child is rather 
pale, and the skin covered with moderate perspiration. 
There are two ways in which the antimony given in this 
manner exercises its curative effect. In the first place, as 
soon as the nausea and vomiting are commenced, the heart 
is brought under the control of the nauseating sedative, in 
which its power to pump blood to the affected parts and 
develop the inflammatory exudation, that is, the false mem- 
brane, is reduced one-half or more. In the second place, 
the relaxation of the system by the constant sickness pre- 
vents the spasmodic paroxysm, and as these paroxysms 
have an intrinsic tendency to increase the congestion of the 
parts involved"in the inflammation, anything that prevents 
their occurrence exercises a curative effect upon the disease. 
As it is proposed to break up and abort all cases of mem- 
branous croup in which the treatment as herein given is 
commenced at the beginning of the attack, it is a waste of 
time to mention other remedies for this disease. The fol- 
lowing is the formula for the tartar emetic : — 

Tartar emetic, eight grains, 

Simple syrup, five ounces. 
Mix, and give a teaspoonful every fifteen minutes until 
vomiting commences. If the symptoms are exceedingly 
violent and the vomiting does not occur within fifteen min- 
utes, two teaspoonfuls may be given. This remedy will 
cure every case of croup if commenced early in the attack. 



172 ACUTE CATARRHAL LARYNGITIS. 

ACUTE CATARRHAL LARYNGITIS. 

Other names : sore throat ; catarrhal laryngitis. This 
is an acute inflammation of the mucous membrane of the 
larynx, and is attended with a slight fever, hoarseness, 
pain on swallowing, and often difficulty in breathing. 

Causes. — The most important of these include atmos- 
pheric changes, draughts of cold air, and all other 
conditions causing persons to contract a severe cold. 
The affection is also due to irritating drug powders or 
vapors. It is also caused by public speaking and singing. 

Symptoms. — It comes on abruptly, the throat feeling 
raw and dry, with a tickling pain in the windpipe. There 
is pain on swallowing and also at any attempt to speak. 
In the early stage of this affection the voice is hoarse and 
soon ceases altogether. In children the fever develops 
suddenly, the tongue is coated, pulse rapid and strong, 
skin hot, the face red, and the child has a croupy cough 
with threatened suffocation. 

Termination. — This is always favorable. 

Treatment. — Patients should be kept in rooms uniformly 
heated and the air kept moist by steam. This can be 
done in a great many ways. If there is a stove in the 
room, water can be evaporated in a large flat dish ; but 
if there is not, large hot rocks may be placed in a pan 
and water poured slowly upon them so as to keep the air 
almost saturated with vapor. 

Cloths wrung out of hot water and wrapped around the 
neck are capable of doing a great deal of good. It is best 
to have them very large so as to hold the heat for a long 
time. The bowels should be thoroughly moved in the 
commencement by a suitable physic. 



ACUTE CATARRHAL LARYNGITIS. 1 73 

In order to procure rest and at the same time get a free 
action of the skin, the following may be given at bedtime 
to adults : Dover's powder and nitrate of potash, of each 
twelve grains. Give this at one dose, and keep the patient 
warmly covered in the bed or with clothing if not in bed. 
If there is much fever and the pulse strong and rapid, 
give tincture veratrum veride in two-drop doses every 
hour for five hours, and then continue it for eight or ten 
hours in one-drop doses. The treatment given here is for 
adults, as the doses are far too large for children. When 
the disease occurs in children, the bowels may be kept 
open by teaspoonful doses cream of tartar, three or four 
times a day in water. In almost all fevers there is a 
craving for acid, and for this reason the cream of tartar 
water will be eagerly taken. To control the heart's action 
and lessen the fever and inflammatory development, the 
following may be given to children from three to eight 
years old : — 

Tincture veratrum veride, ten drops, 
Water, twenty teaspoonfuls. 

Mix ; teaspoonful every hour for ten hours and then 
leave it off for two or three hours, after which continue it 
every hour till it is all given. 

To procure rest for little patients from one to eight 
years old, paregoric may be given in doses ranging from 
four to twenty drops every four or five hours, but care 
must be taken to avoid giving too large doses of opium 
to children, especially to those suffering from throat 
affections, as profound sleep favors the accumulation of 
mucus in the air passages and leads to danger from 
suffocation. 



174 THROAT CONSUMPTION. 



THROAT CONSUMPTION. 

Other names: tuberculous inflammation of the larynx; 
laryngeal phthisis. 

This is an ulcerative inflammation of the larynx caused 
by tubercles, practically the same kind of tubercles that 
exist in pulmonic or lung consumption. The throat con- 
sumption is attended with cough, pain on swallowing, more 
or less loss of voice, great loss of flesh, and fever, in which 
there are usually red spots on the cheeks. 

Causes. — The exciting cause is the action of tuberculous 
parasites upon the larynx. The predisposing causes are 
hereditary. 

Symptoms. — The affection is almost always a complica- 
tion of pulmonary consumption. When it occurs as a 
primary disease lung consumption soon follows. About 
the first symptom noticed is hoarseness or a feeble state of 
the voice. The husky voice may gradually increase until 
only a faint whisper is heard ; at the same time there is 
generally a distressing cough with but little expectoration. 
The act of swallowing is difficult and painful. In addition 
to these symptoms those of pulmonary consumption are 
added, such as loss of appetite, loss of flesh, night-sweats, 
and extreme restlessness. 

Termination. — Always unfavorable. 

Treatment. — This disease is essentially consumption, 
although it may appear, primarily, in the throat instead 
of the lungs. As it is purely a constitutional disease, the 
application of local remedies afford no hope so far as a 
cure is concerned. There is nothing but a change of cli- 
mate, from a low altitude, low temperature, and moist 



THROAT CONSUMPTION. 1 75 

atmosphere to a high, dry, and warm climate, that is calcu- 
lated to afford any hope of recovery. 

There is one general principle that should be observed 
in dealing with consumption either of the larynx or lungs, 
and that is this : Any locality or climate in which the 
disease develops, should be abandoned as soon as possible, 
as a person who passes from a state of perfect health to 
one of constitutional disease under climatic influence, can 
scarcely hope to be restored to normal health under the 
same influences. The climate best suited to consumptives is 
the warm, dry, semi-tropical region of Southern California, 
where the high mountain ranges exclude the northern 
winds and prevent precipitation of moisture in the form of 
rain. For this reason the so-called rain season only lasts 
about five or six weeks in the year, during which there are 
a few light showers. The climate is so mild and uniform 
that patients can live in tents and exercise in the open air 
with impunity. A great many patients who have gone to 
Los Angeles within the last ten years, suffering from lung 
and throat affection, have entirely recovered. But a great 
many people are too poor to go, while others have business 
affairs they cannot readily leave, and in the meanwhile 
something must be done to stay as far as possible the 
ravages of the fell destroyer. It has been fashionable for 
decades to give all consumptive patients cod-liver oil with 
a view of stopping the wasting of flesh. The cases in 
which it succeeds, even though when mixed with whiskey, 
are comparatively few, as consumptives generally have an 
intolerance for oil of any kind and especially this. The 
author, many years ago, substituted cream for the cod- 
liver oil with the most satisfactory results. It is given as 
follows : Put two tablespoonfuls of good cream into a glass, 



176 PNEUMONIA. 

and then pour into it one tablespoonful of pure whiskey. 
Stir it, adding a little sugar if desirable, and give it at 
once. If the whiskey and cream are given in this way, the 
latter will not curdle, but if the cream is poured into the 
whiskey, coagulation immediately follows. The mixture 
should be given just before meals, and under its use the 
cough frequently grows less, the throat symptoms improve, 
and the patient either ceases to lose flesh or gains a few 
pounds. Sometimes, however, the cream is not well borne, 
and in such cases it is worse than useless to give it. 



PNEUMONIA. 

Other names: lung fever; winter fever; pleuro- 
pneumonia ; pneumonitis. 

This is an acute inflammation involving the substance 
of the lungs, the congestion being of such character as to 
render the affected parts of the lung impervious to air. It 
commences with a severe chill, headache, fever, pain in 
the chest, cough and difficulty of breathing, expectoration 
being of a rusty color. 

Cause. — It is said to be an infectious disease, caused 
by parasites. 

Symptoms. — A well-marked case of pneumonia com- 
mences with a protracted chill followed by a high fever ; 
the pulse is full, strong, and rapid, there is sharp pain 
in the chest, caused by each act of breathing or coughing, 
the breathing often being so rapid as to reach forty or 
fifty respirations per minute. The cough is at first harsh 
and dry, but gradually becomes moist, with a discharge of 
frothy mucus that changes by the second day into a rusty 
colored expectoration, characteristic of the disease. There 



PNEUMONIA. 177 

are all the symptoms of a violent fever, the face being 
flushed, sometimes of a bluish red color due to carbonic 
acid poison in the blood, for want of breath. The above 
symptoms, more or less severe, continue for eight or nine 
days, when a crisis sets in attended with profuse perspira- 
tion and symptoms of great prostration ; the fever almost 
entirely subsides, and if the case is destined to end favor- 
ably, recovery speedily follows. 

Unfortunately, a great many cases of pneumonia, after 
having passed through the various stages in a reasonably 
favorable manner, seemingly sink rapidly as soon as the 
crisis is reached and die within a day or two. Such cases 
are exceedingly common in those who have passed the 
meridian of life's journey or gone a little beyond it. 

Termination. — The highest medical authorities claim 
that less than twenty per cent of all cases of pneumonia 
end fatally, but there is something exceedingly deceptive 
in this claim. 

Between the ages of childhood and forty, deaths from 
pneumonia are exceedingly rare, while above forty the 
fatality gradually increases, and after the age of fifty is 
passed, more than half die. A man's intrinsic worth to 
the world is far greater after he has passed fifty than 
during the early part of his life, and it is the province of 
medical art to save him if possible. How can it be done 
in pneumonia ? The expectant plan of treatment, that is, 
waiting for the disease to run its course, is generally fatal, 
as the natural crisis is so long delayed that fatal exhaus- 
tion soon follows. 

Treatment. — Other things being equal, the longer the 
crisis is delayed the greater is the tendency to a fatal 
ending by exhaustion. 



1/8 PNEUMONIA. 

The extent and violence of the inflammation and its 
continued interference with the functions of respiration 
and nutrition cause the exhaustion mainly. The ques- 
tion arises : Is there any way to cut short the destructive 
and strength-consuming stage of inflammation so as to 
save enough of the vital forces to carry a bad case of 
pneumonia to a favorable termination, even when the 
patient has passed the fiftieth or sixtieth mile-post of life ? 
Let us see. Suppose the natural crisis is destined to end 
on the seventh, ninth, or eleventh day of the disease. 
This gives at least a whole week for all the distressing 
and exhausting stages of the inflammation to run their 
course. Now if any drug can be given during the first 
twenty-four or thirty-six hours that will break up the inflam- 
mation and bring on an artificial crisis attended with 
sweating and a subsidence of all the violent symptoms, 
and yet exercise but little prostrating effect upon the 
patient, what could be more rational than the use of such 
a drug ? Exactly such a drug is known to the author and 
has been used by him for thirty years. It is true that it is 
very depressing, that it reduces the force and frequency 
of the pulse to the natural standard if not lower, changes 
the face from red to a peculiar pallor, bedews the skin 
with cold perspiration, often causes sickness and vomiting, 
and may alarm nervous and timid attendants ; but the 
whole period, from the earliest development of the artificial 
crisis until reaction occurs, is less than one-twentieth of 
the time required to establish the natural crisis. The 
artificial crisis arrests the disease during the stage of 
engorgement or congestion, and absolutely prevents the 
various inflammatory stages that always attend the disease 
when it is permitted to run its full and natural course. 



PNEUMONIA. 179 

As it takes the morbid condition twenty times as long 
to bring on the natural crisis as it does the drug to estab- 
lish an artificial one, the logical inference is that twenty- 
times more physical force is used up by the disease than 
by the drug, and a very extensive experience in dealing 
with pneumonia affecting persons of all ages, confirms the 
theory. 

Based upon an experience of thirty years during which 
the abortive treatment of pneumonia has been employed 
in all well-marked cases, the following treatment is given : 
In all cases of pneumonia attended with a full, strong, and 
bounding pulse, high temperature, flushed face, and other 
symptoms indicative of the disease, the following should 
be given as directed, as soon as the reaction from the chill 
occurs : — 

Tincture veratrum veride, a teaspoonful, 
Water, twenty teaspoonfuls. 

Mix, shake, and give a teaspoonful every hour until the 
pulse and fever begin to fall. About this time sickness of 
the stomach will come on, the face will become pale, the 
skin will be covered with cold sweat, the pain, hurried 
respiration, and other violent symptoms will subside, and 
the whole group of symptoms, excepting the sickness of 
the stomach, will be practically the same as those of the 
natural crisis. 

The similarity of the drug effect to the natural crisis is 
further observed in the fact that all the inflammatory 
symptoms permanently subside after the specific effect of 
the drug is obtained. In other words, the crisis, whether 
artificial or natural, practically ends the inflammatory 
process. 

When the artificial crisis is reached within twenty-four 



l80 PNEUMONIA. 

hours, — and it ought to be reached within ten or twelve 
hours, — the disease is broken up before it has time to 
exercise much, if any, prostrating effects, and also before 
it has time to produce permanent organic changes in the 
lungs. The depressing effects of the remedy are transient, 
wholly disappearing in a few hours, and the patient is 
practically well in three days. 

When the disease is permitted to run its course, the 
crisis is liable to be followed by fatal prostration, and this 
liability is greatly increased if the patient is advanced in 
years. If, however, enough strength is conserved through 
it all to prevent a fatal ending, the patient, even if young, 
is liable to be left with a crippled respiratory apparatus, — 
a partially consolidated lung that is worthless. Under the 
system of practice in vogue fifty years ago, certain symp- 
toms were given calling for blood-letting. The principal 
ones were a strong, full, frequent, and bounding pulse. 
These were few and easy to remember, and afforded a 
general guide to doctors in treating inflammatory affec- 
tions in those days. Exactly the same symptoms call for 
the use of an arterial sedative, such as veratrum veride, in 
all acute and violent inflammations, especially pneumonia. 

The time in which to give this sedative is of the utmost 
importance. It should be given as soon as possible after 
the chill subsides, but at this early stage of the disease its 
character can only be suspected. It cannot be positively 
known, but if the full, frequent, and bounding pulse is 
present the sedative should be given on general principles, 
as an inflammatory seizure of some kind is imminent. 
Should it not be given until twenty-four hours after the 
initial chill, the chances of wholly aborting the inflam- 
mation, that is of breaking it up during the stage of 



SPASMODIC LARYNGITIS. l8l 

congestion, are much less than if given at the commence- 
ment; but it should be commenced just the same, and 
followed for fifteen hours with the hope of terminating 
the disease in its first stage or greatly modify its subse- 
quent force. 

After the disease is developed, and the lung is fully 
involved in the inflammatory process, the arterial sedative 
can do nothing but harm. During this and subsequent 
stages of the disease, what is known as the supporting 
treatment, such as quinine, iron, alcoholic stimulants, and 
animal broths, is the best. But this idea cannot be urged 
too strongly : The golden opportunity is during the first 
twenty-four hours when the disease ought to be broken up 
by the sedative. 

SPASMODIC LARYNGITIS. 

Other names : false croup ; spasmodic croup ; child- 
crowing. 

This is an inflammation of the mucous membrane of the 
larynx, attended with a spasmodic contraction of that part 
of the air passage known as the glottis. 

Causes. — The principal cause is the sudden contraction 
of a violent cold. 

Symptoms. — The paroxysm comes on chiefly in the night, 
and may affect a child that a few hours previous seemed to 
be in a perfect state of health. The little patient is aroused 
from sleep in an agonizing state of suffocation, has a sharp, 
dry cough, hot fever, face flushed, and general symptoms 
of distress. Within an hour or so the breathing becomes 
easier, the cough moist, and the child falls to sleep. On 
the following day the cough is loose and easy, the breathing 



1 82 SPASMODIC LARYNGITIS. 

natural, and the patient seems practically well ; but if the 
proper treatment is not followed during the day, the par- 
oxysm comes on the second night about the same time, 
but usually less violent. The child is well during the fol- 
lowing day, and on the third night another very slight 
paroxysm occurs, and this is usually the end of the trouble. 

If the first paroxysm does not abate during the day, but 
is accompanied with inflammatory symptoms for two or 
three days, there is danger that the true croup may set in. 

Termination. — False croup is almost always favorable in 
its termination. 

Treatment. — The best thing to break the paroxysm, 
which is always nervous in false croup, is to put the child 
in a tub of warm water. If the paroxysm does not yield 
to the use of the warm bath in fifteen minutes, an emetic 
should be given, and at this point arises a question of the 
greatest importance in dealing with croup, whether true or 
false. The false croup always terminates favorably. The 
true croup is always dangerous and should receive prompt 
and radical treatment from the first. Should the false 
croup be mistaken for the true, and treated accordingly, 
such treatment might be unnecessarily severe, but would 
not injure the child. On the other hand, if the true croup 
is mistaken for the false, and so treated, the disease will 
get so fully developed before its true character is deter- 
mined as to greatly endanger the life of the child. Doctors 
frequently make mistakes by failing to recognize the form 
of disease they are dealing with, and of course mothers and 
fathers are much more liable to commit the same error; 
therefore it is always safer to treat every case of croup as 
if it were the worst form of the disease, and in that way 
arrest the inflammatory development, should it be the true 



SPASMODIC LARYNGITIS. 1 83 

membranous croup, and save the child. This can probably 
be done in almost all cases. Therefore get the following 
mixture put up, keep it in the house, and when croup 
shows itself in any child, give a teaspoonful every fifteen 
minutes until vomiting begins : — 

Tartar emetic, eight grains, 

Simple syrup, five ounces, 

Alcohol, one ounce. 
Mix ; dose, a teaspoonful every fifteen minutes until 
vomiting commences. After it once commences the child 
will be sick more or less for several hours, probably most 
of the night, and will vomit every hour or so. This is all 
very desirable, as it acts as a sedative to the heart's action 
and arrests the croup. There is usually more or less spas- 
modic croup in connection with the true croup, and this is 
always relieved by the relaxing effect of emetics. 

The folly of trying to distinguish between the mild and 
grave forms of croup, and thus taking chances of making 
a fatal mistake, ought to be readily apparent to every 
father and mother, and the treatment herein given will save 
every child if the directions are carefully followed. It is 
not claimed that it will save every patient unless it is com- 
menced soon after the attack. In croup, as in all other 
inflammatory affections, the golden opportunity in which 
to arrest the disease is during the first two or three hours 
after its commencement. 

Unfortunately, this time is often wasted in hunting for 
some particular physician, and by the time he is found, the 
opportunity to save the child is past. 



1 84 DIPHTHERIA. 



DIPHTHERIA. 



Other names : malignant quinsy ; putrid sore throat. 

This is an acute, specific disease, both epidemic and 
contagious, commencing in the throat, and characterized 
by the appearance of small white patches upon the ton- 
sils which run together, forming a white membrane that 
gradually extends to other parts. The glands of the 
throat and corners of the jaw are swollen and sore, there 
is usually a burning fever, the temperature sometimes 
rising to a hundred and five or more. It is generally 
understood that the grave character of the disease is in 
direct proportion to the height of the fever. 

Causes. — A specific germ that exists in the atmosphere. 

Symptoms. — It may be mild and slow in its develop- 
ment, the chills or chilly feeling being followed by mod- 
erate fever, headache, loss of appetite, soreness about the 
angles of the jaw, and slight tenderness of the throat caused 
by swallowing. 

In other cases the disease may come on suddenly with 
a severe chill, followed by intense fever, rapid swelling of 
the glands at the angles of the jaw, great pain on swallow- 
ing, aching of the limbs, loss of strength, loss of appetite, 
and bowels relaxed. On examination the throat is found 
to be red, the tonsils enlarged and partly covered with the 
white exudation or membrane that always determines the 
true nature of the disease, as such a membrane is not 
found in other affections. 

Termination. — As the disease is usually treated it is one 
of the most dangerous maladies that afflict children. It is 
an unfortunate thing that the medical profession has never 
settled upon a definite treatment, but, from time immemo- 



DIPHTHERIA. 1 85 

rial, has pursued a course purely experimental, always 
totally unreliable, and always, in grave cases, void of satis- 
factory results. 

Many years ago, the author, who had had a sad experi- 
ence with diphtheria, set out to find a remedy that would 
break up the disease at once by killing the parasites 
secreted in the mucous tissues of the throat, as the throat 
has always been the focus of infection. 

As he regarded the disease mainly as a local affection 
in its commencement, he naturally thought any remedy 
that would destroy the infecting germs, would prevent the 
deplorable and prostrating effects of blood-poison that are 
so often fatal. His first and only selection of a remedy 
was carbolic acid, as follows : — 

Pure carbolic acid crystals, melted by heat, one ounce, 

Pure olive oil, three ounces. 

Mix. 

There must be no water whatever used in dissolving 
the acid, for if there is, the mixture will be muddy. It 
should be almost exactly the color of olive oil. 

If this remedy is timely and thoroughly used, it will cure 
every case of diphtheria, and as much depends upon the 
thorough way in which the work is done, the following 
full and explicit directions are given : Take a stick of the 
proper length and about as large as a common lead pencil. 
Around this stick, cut a notch close to the end. A half 
inch from this, cut another. Then wrap a piece of white 
muslin several times round the stick, allowing it to project 
three-eighths of an inch beyond the end. Tie it securely 
by two strong threads, one at each notch. Pour a little of 
the remedy in the bottom of a teacup, dip the swab into it 
until it is well soaked, then rub it carefully on the edge of 



1 86 DIPHTHERIA. 

the cup so it will not be dripping wet. Next take a large 
tablespoon, holding it right side up, and with the handle 
press down the tongue. The spoon should be pushed well 
back, and will almost always make the child "gag." This 
is the golden opportunity for applying the remedy to every 
part of the throat, and the work should be done in a very 
few seconds, turning the mucous membrane of the throat 
as white as milk. Even if these membranes are only 
partially affected at the time, the parasites are there and 
must be destroyed. 

The disease never extends to the parts thus treated, 
and where the cases are taken in hand during the first 
twenty-four hours and treated in this way, it is rarely 
necessary to repeat the operation or to give other treat- 
ment. 

That diphtheria is, practically, a local disease in its com- 
mencement, that a local treatment is an absolute necessity, 
and that the plan of treatment herein given is the cor- 
rect one, the following is submitted as a proof : In such 
epidemics as were attended with great mortality under 
other methods of treatment, there were absolutely no 
deaths when this drug was used. When called to see 
cases during the second day of the attack, it was often 
found difficult to save them, but where other cases occurred 
in the same family and the carbolic acid treatment was 
used, the child would be about well on the following day. 

From the unfailing success of this quick, easy, and 
simple treatment, the author has long since ceased to 
regard diphtheria as a dangerous disease, and it does not 
seem that one case in a hundred should be lost if the 
carbolic acid and sweet oil plan is skilfully carried out. 

In using the swab, care must be taken not to have it 



DIPHTHERIA. 1 87 

dripping wet with the drug so it will run down the throat 
or spread extensively to the parts not touched. It is only- 
necessary to touch the parts affected with the wet swab 
in order to turn them white, and every parasite secreted 
in the membranes thus whitened is instantly killed. It 
is not possible for any one to see the parts that are being 
touched by the swab, as children always struggle, but after 
the treatment is over, a glance into the throat will show 
exactly what has been done, as the membranes touched 
will be milk-white. In a large number of cases operated 
on in this way no symptoms of poisoning from the car- 
bolic acid were ever observed, and yet it is best not to use 
too much of the medicine to commence with, knowing that 
if the parts are not sufficiently whitened at first, another 
application can be made in two or three hours. The best 
caution that can be given to prevent the remedy from run- 
ning down the throat is this : Get the swab thoroughly 
wet in the solution, then press it against the sides of the 
teacup until it ceases to run. If it will not run down 
the sides of the teacup when thus pressed it will not run 
down the throat. 

The terribly poisonous character of this remedy has no 
doubt prevented its successful employment in diphtheria. 
A watery solution would probably be very dangerous, as 
it would be liable to run down the gullet, but an oil mix- 
ture, with anything like reasonable care, is not. When it 
is a well known fact that the focus of infection, or starting 
point of the disease, is in the throat, and in ninety-nine 
per cent of the cases within easy reach of an unfailing 
local application, the folly of using antitoxine or any other 
blood-poisoning injection, is readily apparent. As anti- 
toxine has been used quite extensively by hypodermic 



1 88 HEMORRHAGE OF THE BRAIN. 

injection to cure diphtheria, and in many cases with fatal 
results, it deserves a passing notice. With reference to 
that remedy, if it can be called a remedy, there is one 
puzzling question that confronts us : Will the system of 
any patient tolerate enough poison, when injected into the 
blood, to destroy the parasites that caused diphtheria? 
The attempts that have been made to get a satisfactory 
answer to this question by injecting antitoxine, have cost 
many children their lives. The injection of any remedy 
into the blood is radically wrong, because the parasites 
are located in the throat and can be easily killed by a drug 
applied locally, that is a thousand times stronger than the 
system would bear if injected into the blood, and there is 
no guessing at results, as every parasite is destroyed, and 
the disease arrested. If all cases of diphtheria are treated 
locally as recommended above, and the application is 
made as soon as the white patches make their appearance 
in the throat, the use of tonics, such as quinine and iron, 
with alcoholic stimulants to overcome the prostrating 
effects of blood-poisoning, will seldom if ever be necessary. 
The early and thorough employment of this treatment 
will prevent its extending to the larynx, or windpipe, and 
causing death from diphtheritic croup. 

HEMORRHAGE OF THE BRAIN. 

Other names: apoplexy; "a stroke." 

This disease comes on suddenly from bursting a blood- 
vessel in the brain, and the escape of blood into the brain 
substance, causing undue pressure upon that part of the 
brain at which the hemorrhage occurs, and ultimately more 
or less destruction of brain tissue. It is characterized by 



HEMORRHAGE OF THE BRAIN. 1 89 

complete and sudden unconsciousness, irregular and ster- 
torous breathing, with absolute relaxation of the muscles. 

Causes. — The disease is almost always confined to those 
who have passed the meridian of life, the main cause being 
disease of the blood-vessels. It may also be due to intem- 
perance in the use of alcoholic stimulants and also in eating. 
Enlargement of the heart, in which the muscular structure 
is greatly increased in volume and strength, is not an infre- 
quent cause, as the blood is thrown with such force as to 
greatly endanger the vessels. Fright, intense grief, and 
mental anxiety are all important factors in causing a stroke 
of apoplexy. 

Symptoms. — Apoplexy usually comes on suddenly, but 
not always. The vessels ruptured are sometimes so very 
small that it takes considerable time for enough blood to 
accumulate to cause the " stroke." The usual premonitory 
symptoms are headache, dizziness, the patient being more 
or less blind, with numbness of the limbs, and often a 
powerless condition of some of the muscles. Vomiting 
frequently precedes the "stroke," the breathing immedi- 
ately becoming slow and irregular, with a puffing sound. 
The cheeks are usually blown outward at each expiration. 
The pulse is slow and full, and the eyes are insensible to 
light. The face is flushed, and yet there is no fever until 
several hours after the attack. The muscular system is 
thoroughly relaxed. 

Sooner or later reaction occurs as a general thing. 
Sometimes it commences within an hour, at others it is 
delayed for several hours. A return of the senses brings 
headache, the mind is wandering and confused, and one 
side of the body is usually paralyzed. 

During reaction inflammatory symptoms may set in, 



190 HEMORRHAGE OF THE BRAIN. 

attended with a high fever, and the paralyzed muscles may 
become rigid. In such cases there is frequently severe 
shooting pains. 

Termination. — The great gravity in apoplexy consists 
in the fact that one attack predisposes to another, and if 
the first is not fatal a subsequent one is almost sure to be. 

Treatment. — If a stroke is preceded by premonitory 
symptoms, it shows that slow hemorrhage is probably tak- 
ing place in the brain, and the best thing to be done in 
order to relieve the pressure upon the arteries and stop 
the hemorrhage is blood-letting. This should be done in 
the old-fashioned way, by opening a vein in the arm and 
drawing off a pint or more of blood. 

During the attack the tendency to hemorrhage of the 
brain may be lessened by elevating the head, and this 
should be done immediately. The patient should be on 
his side with the face inclined a little downward to prevent 
the choking effect of the mucus and saliva, that might 
otherwise accumulate in the throat. If when reaction is 
established the pulse should be full and bounding, a seda- 
tive to the heart's action should be given, and the best is 
the tincture veratrum veride as follows : — 

Tincture veratrum veride, one drachm, 
Water, three ounces. 

Mix, and give a teaspoonful every hour until the strong 
and bounding character of the pulse is lessened or until 
sickness of the stomach occurs. 

If an attack is marked by pallor of the countenance and 
feeble and irregular pulse, a tablespoonf ul of whiskey in 
an equal amount of sweetened water may be given every 
hour until the condition commences to improve. After all 
the acute symptoms of an apoplectic seizure have subsided, 



SICK HEADACHE. 191 

iodide potassium may be given in ten-grain doses three 
times a day to cause absorption of the blood clot in the 
brain. 

The following is a convenient form for giving it : — 

Iodide potassium, three drachms, 

Simple syrup, nine ounces. 

Mix, and give a tablespoonful three times a day. 
After a month or two the paralyzed condition may be 
favorably affected by giving the solid extract of ignatia 
three times a day before meals, the dose ranging from one- 
half to a full grain according to the size of the patient, a 
full grain being intended only for the largest and strongest 
men. 

SICK HEADACHE. 

Other names ; bilious headache ; blind headache ; mi- 
graine ; hemicrania. 

This is a paroxysmal pain or aching in the head, usually 
periodical, attended with sickness and vomiting and a 
morbid sensibility of the nervous system. The affection 
is aggravated by sound, disturbed by strong light and ob- 
noxious odors. The smell of tobacco smoke greatly in- 
tensifies the sickness and headache. 

The causes are largely hereditary, that is, patients inherit 
an irritable, nervous disposition that favors the develop- 
ment of atonic dyspepsia, and the dyspepsia in a large 
majority of cases causes the sick headache. There are a 
great many cases of the disease, however, that are not 
traceable to any known cause, and yet permanently yield 
to such a course of treatment as cures dyspepsia, even 
though the latter does not seem to exist. There is noth- 
ing in the way of diet or habits of living that is so great 



192 SICK HEADACHE. 

a factor in causing sick headache as the use of tea and 
coffee, but more especially the latter. In a large per cent 
of the obstinate cases of sick headache the patients are 
excessive coffee drinkers, some of them taking one or two 
strong cups three times per day. Others drink two cups 
at each meal, and the number of persons who can drink 
coffee thus intemperately and not be afflicted with frequent 
and severe paroxysms of headache, are certainly very few. 

Symptoms. — The attacks of this disease come on in 
irregular paroxysms, each attack seemingly ending in per- 
fect recovery. The paroxysms usually have warning symp- 
toms which are mainly disorders of digestion. 

The headache may commence with a feeling of chilliness 
followed by nausea and vomiting, or the chilly feeling may 
be entirely absent. There is often soreness of the muscles 
somewhat like muscular rheumatism, and the patient is 
disturbed by strong light, by unusual sounds, or anything 
calculated to disturb in the least the nervous system. 
About this time pain of a severe character sets in. It may 
be darting like neuralgia or it may be an intense aching 
pain over the eyes, in one or both temples, or in the back 
of the head. The pain is usually felt on the left side and 
very rarely felt on both sides at once. 

The sickness of the stomach, instead of preceding the 
pain, as it sometimes does, more frequently commences 
with it and accompanies it, the greatest nausea and vomit- 
ing being apparent during the greatest intensity of the 
headache. 

Motion, light, sound, disagreeable odors, and everything 
that perturbs the nervous system, aggravates the suffering. 
These attacks, if not cut short by drug treatment, may last 
for two or three days. 



SICK HEADACHE. 193 

Termination. — The disease is not only free from danger 
to life, but almost all cases, under the right treatment, can 
be permanently cured. 

Treatment. — The first thing to be done is to break up 
the paroxysm, which can be done with either one of two 
remedies. Sulphate of morphine given in pill form, sugar 
coated, in one-fourth-grain doses every half-hour until the 
patient is entirely relieved, is, perhaps, the best, unless that 
intense sickness of the stomach, characteristic of morphine, 
should make its use undesirable. If it is given, however, 
as directed, the third pill will rarely if ever have to be 
given. The other remedy is antipyrine, and in severe 
cases may be given in twenty-grain doses. The first dose 
will afford within one hour partial relief, but it is usually 
necessary to give the second dose within an hour and a 
half from the first. This almost always breaks up the 
paroxysm. 

THE CURATIVE TREATMENT. 

There is a permanent and almost infallible cure for this 
terrible affliction, if the proper remedy is taken for a suf- 
ficient length of time, and the advices regarding eating and 
drinking carefully followed. In the first place coffee, if 
used at all, must be abandoned. It is better to avoid the 
use of stimulants of every kind ; but if something in that 
line must be taken, a cup of tea at breakfast may be used 
instead of coffee. Granting that this wonderfully pleasant 
beverage, coffee, is to be permanently abandoned, the next 
thing is to select a remedy that will so act upon the nervous 
system, and so change it, as to break up the headache habit. 
The remedy is well known to the author, and has been 



194 SICK HEADACHE. 

successfully employed by him in these cases for thirty 
years. 

It is the solid extract of ignatia amara, given in doses rang- 
ing from one-half to a full grain three times per day before 
meals. If a person weighs from a hundred to a hundred 
and sixty pounds, a one-half-grain pill is sufficient ; if from 
one hundred and sixty to two hundred, a three-quarter of 
a grain pill must be given. All persons weighing over two 
hundred should take a one-grain pill. All adults, even 
though they may weigh less than a hundred pounds, will 
bear a half-grain pill. Children from eight to fifteen years 
old may take a quarter-grain pill, and in those below eight 
sick headache rarely if ever occurs. 

It seems that the merits of this remedy are almost wholly 
unknown to the medical profession, as the impression gen- 
erally prevails that ignatia is about the same as nux vomica, 
or its more active principle, strychnine. The facts are, that 
ignatia, though chemically very similar to nux vomica, has 
medical properties wonderfully superior, and also vastly 
superior to strychnine, and covers a wider range of nervous 
and dyspeptic disorders than any other remedy known in 
medicine. 

When it is given to cure sick headache or any other 
affection that has existed for many years, it must be re- 
membered that the primary cause of the disease has to be 
removed, and the habit of its occurrence broken up. For 
this reason, when sick headache has existed for fifteen or 
twenty years it is foolish to suppose that any treatment 
will cure it in a month or two. Therefore the remedy 
should be given three times a day without a miss for six 
months or more, where it has existed for many years. 
If it is much more recent in its origin, that is, if it has 



CONGESTION OF THE BRAIN. 1 95 

only existed for two or three years, three months will prob- 
ably be long enough to continue the drug. 

CONGESTION OF THE BRAIN. 

Other names : cerebral congestion ; cerebral hyperaemia. 

This is an unnatural fulness of the vessels of the brain. 
When the congestion involves the arteries, it is called active 
congestion. When the veins are mainly involved, it is 
called passive congestion. The affection is attended with 
headache, dizziness, and sometimes convulsions. 

Causes. — In the active form it may result from enlarge- 
ment of the heart, causing a flow of too much blood to the 
brain, and unduly distending the vessels. 

Excesses in eating lead to a fulness of all the blood- 
vessels by creating too much blood, and in this way are 
liable to cause brain congestion. Alcoholic stimulants, 
sunstroke, great anxiety, or severe mental labor, all have a 
tendency to cause cerebral congestion. 

Symptoms. — Congestion of the brain may come on 
suddenly or may develop gradually, and the symptoms are 
liable to be aggravated by the horizontal or recumbent 
position. It is characterized by headache, neuralgic pains, 
and derangement in the senses of vision and hearing, ring- 
ing in the ears, dizziness, contracted pupils, a "rattled" or 
stupid condition of the intellect, and weird hallucinations ; 
the face is congested, eyes suffused with tears, or there is 
more or less twitching of the muscles. 

Termination. — This is more or less unfavorable so far 
as perfect recovery is concerned, but the cases that end 
fatally are comparatively few. 

Treatment. — In the active form of the disease the appli- 



196 DYSPEPTIC MELANCHOLY. 

cation of cold water to the head in immense quantities, so 
as to completely overwhelm the morbid action, is the best 
treatment that can be adopted, but in the meantime the 
head should be sufficiently elevated to allow the force of 
gravity to assist in carrying the blood away from the brain. 
In using water a great deal depends on the amount and 
the temperature, and a wash-tub full is not too much as a 
general thing. A physic of Epsom salts, to the amount of 
two tablespoonfuls, may be given in half a glass of water 
if the patient can swallow. 

In all cases where the symptoms are violent and attended 
with a strong, full, and frequent pulse, the following should 
be given as directed : — 

Tincture veratrum veride, one drachm, 
Water, two and a half ounces. 

Mix ; dose, a teaspoonful every hour. Within eight or 
ten hours the fever and pulse will probably be greatly re- 
duced, preceded by sickness of the stomach and vomiting. 
These changes are the characteristic effects of the drug, 
and when the distressing symptoms subside in this way re- 
covery is usually rapid ; but should the nausea and depres- 
sion from the drug be great, a tablespoonful of whiskey in 
an equal amount of water may be given to hasten reaction. 

DYSPEPTIC MELANCHOLY. 

This is one of the forms in which dyspepsia manifests 
itself. In such cases the patient is called a hypochon- 
driac, or a subject of hypochrondia. He is very much 
depressed in spirits, and imagines he has an incurable mal- 
ady of some kind. The tendency of such patients is to 
brood over their physical infirmities, and allow themselves 



ANGINA PECTORIS. 1 9/ 

to be haunted with ideas of cancer of the stomach or some 
terrible affection from which there is no escape. It is hard 
to convince them that dyspepsia, originating in nervous 
debility, is the cause of all their misery and painful abstrac- 
tions. Many cases of insanity are traceable to stomach 
derangements, and in all such affections attended with 
profound melancholy, there is a tendency to suicide. Mel- 
ancholy itself is a mental derangement, and when it reaches 
a condition in which it is incurable, it is called insanity. 

Termination. — Under prompt and proper treatment this 
is almost always favorable. It consists in giving from a 
half to a full grain of the solid extract of ignatia before 
each meal. If a person weighs from ioo to 160 pounds, 
he should take a half-grain pill ; if from 160 to 200, three- 
quarters of a grain will be the proper dose. All persons 
weighing over 200 pounds, should take a full grain. In all 
cases the drug should be continued for three or four 
months. In cases of very long standing it may be best to 
keep up the treatment for six months. 

Under the use of the remedy there is rapid improvement, 
which usually sets in during the first week. It is unneces- 
sary to prescribe anything else, as the ignatia is worth 
more in such cases than all other drugs in the materia 
medica. 



ANGINA PECTORIS. 

This is a disease in which there are sharp pains in the 
region of the heart, usually reaching the left shoulder and 
arm. 

Causes. — It is often due to a hereditary tendency. It 
may also be associated with fatty degeneration of the 



198 ANGINA PECTORIS. 

heart and disease of the valves, but its true place is among 
nervous disorders. 

It has for its exciting causes in many cases, the exces- 
sive use of tobacco and alcoholic stimulants. 

Symptoms. — The attacks occur in paroxysms, are irreg- 
ular in character, commence with but little, if any, warning, 
and when the patient is seemingly in a state of perfect 
health. 

A person attacked with it screams out suddenly as one 
in a fit of epilepsy ; the pain is terrible, with a feeling of 
cramp in the chest, especially in the region of the heart. 

Termination. — It is considered a very grave disease, and 
in bad cases any paroxysm is liable to prove fatal. 

Treatment. — Neuralgia of the heart has heretofore been 
thought incurable, but in the last few years a remedy has 
been found that has proven a specific in some of its forms. 
This remedy is the cactus grandiflorus, or night-bloom- 
ing cereus. It is given as follows : — 

Tincture cactus grandiflorus, twenty drops, 
Water, twenty teaspoonfuls. 

Mix, and give a teaspoonful every ten minutes until the 
patient is relieved. 

In using this remedy it is best to buy the green tincture. 
When in the course of an inflammatory rheumatic attack, 
there is the sudden setting in of a constriction in the 
region of the heart, as if the heart were grasped with a 
band of iron, this remedy is of the greatest importance, 
and almost always acts like a charm. 

As a preventive of the paroxysms, one drop in a tea- 
spoonful of water three times a day may be taken for a 
week, and then suspended if no symptoms are noted. 
The sulphate of morphine in pills from one-fourth to a 



SNAKE-BITE. 1 99 

half grain, according to the severity of the symptoms, 
should be resorted to in case the treatment directed does 
not relieve promptly. 

SNAKE-BITE. 

It is scarcely necessary to burden the reader with the 
symptoms arising from the bite of a rattlesnake or copper- 
head, as the man that is bitten by such snakes will know 
it ; and if he lives very long, will become thoroughly famil- 
iar with the symptoms until he passes into a state of un- 
consciousness. 

Fortunately, a rattlesnake is never looking for an oppor- 
tunity to bite any one, and if unmolested, never " strikes." 
Before striking, he gathers himself into a coil and is then 
prepared to jump about one-third of his entire length. 
When ready to make the jump and inflict the wound that 
is often fatal to the one he bites, he shakes his tail, and the 
sound of his " rattles " gives warning of the deadly stroke 
he is liable to make; and even then, if not further en- 
croached upon, he may not bite. He is utterly helpless 
when stretched to his full length, and for this reason, it is 
hard to get him to strike at a dog. He seems to know 
that the dog will get hold of him before he can get back 
into his coil so as to defy the canine. The dog under- 
stands the snake just as well as the snake does the dog, 
and will never try to get hold of him as long as he keeps 
in his coil, but will bark, jump toward him in a threatening 
way, and do everything to tempt the snake to strike at 
him. Finally the snake gets desperate, jumps at the dog, 
but the latter always dodges him, and before the poor 
snake can get himself back in a coil ready to strike again, 



200 SNAKE-BITE. 

the dog catches him in the middle and shakes the life out 
of him. Dogs rarely if ever get bitten by a snake. 

The effects of a snake-bite upon a man, depend upon 
the location of the bite with reference to blood-vessels. If 
one of the fangs enter a vein, the poison passes at once 
into the circulation, and death ensues before there is any 
time for remedies. If the part bitten is not covered by 
clothing, a great deal more poison enters the body than 
would if the flesh were covered by a thin stocking, and 
the treatment should be very prompt and thorough. 

Treatment. — The best thing to be done after a person 
is bitten is to touch the wound as soon as possible with the 
strongest solution of carbolic acid, as that kills every par- 
ticle of the poison that is not already taken into the circu- 
lation. Nitrate of silver, sulphuric acid, or nitric acid may 
be used if the carbolic acid is not to be had, or the part 
bitten may be touched with a hot iron. 

A great many remedies are popular among people living 
in countries infested with rattlesnakes and copperheads, 
and among them may be mentioned the habit of binding a 
large piece of warm and bleeding chicken upon the wound. 
Another favorite treatment is to put the foot, if that is the 
part bitten, into a bucket full of blue mud obtained from the 
bottom of a foul and sluggish stream. They usually keep 
the foot in such mud for hours. It is scarcely possible for 
any such treatment to be of benefit. The best remedy 
known to antidote the poison of such snakes, is whiskey 
or some form of alcohol. The tendency of persons bitten 
is to pass into a state of fatal stupor, and whiskey is given 
with a view of counteracting it. 

It is foolish to give it in tablespoonful doses, as such 
quantities can have but little effect upon the poison or the 



COMMON HEADACHE. 201 

patient. The writer remembers one particular case that 
occurred in his practice that will afford some reliable infor- 
mation to the reader. He was called to see a boy sixteen 
years old that had been bitten by a rattlesnake a half hour 
before his arrival. The foot was considerably swollen and 
the patient was in a condition somewhat alarming, as the 
symptoms were similar to those of poison from morphine. 
He was given a half pint of whiskey immediately. This 
soon began to act favorably in overcoming the stupor, and 
was followed in an hour by smaller doses amounting to a 
pint in all, and the boy was practically well by the following 
morning. 

COMMON HEADACHE. 

This is one of the most common ailments of humanity, 
as nine out of ten of the adult population of the civilized 
world have it more or less. 

The predisposing cause is heredity, as the inclination to 
headaches runs in families. The exciting causes are dys- 
pepsia, the immoderate use of tea, coffee, and alcoholic 
stimulants. Among the exciting causes, coffee, though one 
of the most pleasant drinks known to mortals, holds a front 
rank. 

There are but few persons who drink coffee to any 
extent that are not subject to headache. Some of the 
attacks are moderate, consisting of a dull headache lasting 
for a day or two, while others are so severe that the patient 
is compelled to go to bed. There are other cases in which 
the headache lasts for a week at a time but is not severe. 
There are others in which the paroxysms occur once per 
month, or at wider intervals. When not accompanied with 
sickness of the stomach, they are not called " sick head- 



202 PALPITATION OF THE HEART. 

ache," but are known as " common headache," but are all 
cured by the treatment given in the chapter devoted to 
"sick headache." 

It is unnecessary to repeat the treatment here, as the 
reader can easily turn to " sick headache " and find the 
treatment for " common headache." 



PALPITATION OF THE HEART. 

Other names : irritable heart ; fluttering of the heart. 

This is a functional disease of the heart in which its 
beats are so fast that the pulse at the wrist can scarcely be 
counted. 

Causes. — A great many causes of this affection are 
enumerated by authors, but the principal one is undoubt- 
edly dyspepsia, as palpitation of the heart always accom- 
panies that disease, more or less. 

Symptoms. — As nine-tenths of all the cases of palpita- 
tion of the heart, and probably a great deal larger per 
cent than this, are due to dyspepsia, the symptoms of the 
affection arising from that cause are given, and are about 
as follows : After eating a very hearty meal or partaking 
of indigestible food, a feeling of distress in the stomach 
occurs, with more or less difficulty of breathing and general 
feeling of discomfort. About this time a rapid fluttering 
of the heart may set in, the heart beating violently against 
the walls of the chest, its pulsations being apparent through 
the patient's clothing ; there is frequently shortness of 
breath, dizziness, and an expression of general anxiety. 
These symptoms are not all present in any one case, as the 
disorder is greatly modified in its symptoms by the tempera- 
ment of the patient. Some are unable to lie down, owing 



PALPITATION OF THE HEART. 203 

to a feeling of suffocation that follows. Others become 
feeble and tottering soon after the seizure, and are com- 
pelled to lie down. 

Termination. — So far as life is concerned this is almost 
always favorable, as palpitation of the heart is a functional 
disease as a general thing ; but there are few patients in 
whom habitual palpitation is once fully established, that 
ever entirely recover from it. 

Treatment. — In this as in all other diseases the most 
important thing to be done is to remove, if possible, the 
cause. Next to this in importance is to find a remedy 
that will break up at once the paroxysms when they oc- 
cur. As most cases are associated with chronic indiges- 
tion and depending upon it, the treatment must be directed 
to the stomach and bowels through the action of drugs 
upon the nervous system. As this is essentially a treat- 
ment of atonic dyspepsia, the reader is referred to the 
chapter on that disease and assured that when the stomach 
and intestinal indigestion are overcome, the paroxysms of 
palpitation will occur much less frequently, if at all. It 
is well to remember, however, that in all disorders of a 
nervous character, certain organs acquire certain habits, 
and when these habits have long continued, they are hard 
to break up. For example, epileptic convulsions may 
commence early in life from a certain or specific cause. 
After a great many " fits " have occurred they will probably 
continue, even though the cause that originally produced 
them has long since ceased to exist. 

The frequent recurrence of palpitation seizures ceases 
to be distressing to a patient, provided he has learned some 
easy and simple remedy to break up the attack. Such 
a remedy was discovered by the author over thirty years 



204 PALPITATION OF THE HEART. 

ago, has been used by him ever since, and rarely fails to 
stop the palpitation in a few minutes. The manner in 
which it was discovered is as follows : Hiccough, which is 
a spasmodic affection, is almost always controlled by a 
patient taking a full inspiration and holding his breath as 
long as possible. As the author considered palpitation of 
the heart a nervous disorder, he tried the same treatment 
with all patients as that used for hiccough. If the palpita- 
tion is of the character that permits patients to lie down, 
they should stretch themselves upon a lounge or bed imme- 
diately, and after a few minutes quiet repose, be directed 
to fill the lungs as full as possible with air and hold it for 
a half minute or more. The palpitation usually ceases 
within a few seconds after the lungs are completely dis- 
tended, and when it once stops it seldom if ever com- 
mences again that day or night. So far as that paroxysm 
is concerned, it is completely broken up. This is a remedy 
that never wears out, as the effects of drugs do sooner or 
later, but is valuable and usually unfailing during the life 
of the patient. Should the first effort at holding the 
breath fail to stop the palpitation, another effort of exactly 
the same kind should be made after the lapse of five or 
ten minutes. There is one important point always to be 
observed and that is this : In obstinate cases the shoul- 
ders should be thrown back and every cubic inch of air 
sucked into the lungs that they will hold. Where a fail- 
ure occurs in the first effort it is almost always owing to 
a trifling effort at inflating the lungs, and next time a 
stronger, deeper, and fuller breath must be taken. 



INFANTILE COLIC. 205 

INFANTILE COLIC. 

This is one of the most frequent and annoying troubles 
of the human race. Many babes, although growing 
rapidly and seemingly healthy, have green stools more or 
less, showing imperfect digestion. In all cases attended 
with green stools there is colic, and this may be so distress- 
ing as to keep the infant crying most of the night. The 
parents give it hot teas, peppermint, and various remedies 
to stop the pain, and, unfortunately, sometimes give it 
paregoric or something of that kind which further inter- 
feres with the functions of digestion, binds the bowels, and 
increases the liability to colic. 

Treatment. — This consists in the first place in giving a 
remedy to act on the whole intestinal tract so as to get rid 
of curdled and irritating food, including the green stools. 
Therefore give the following : — 

Mercurius, the first decimal trituration, ten grains. 
Divide into five powders and give one every hour, by 
mixing it with a little white sugar and putting it in the 
mouth in a dry condition, and washing it down with a 
teaspoonful of milk or water. By the time all the powders 
are given, the stools will be dark and will gradually change 
to brown. After this, give the babe one-twentieth of a 
grain of the solid extract of ignatia three times per day, 
allowing about six hours between each dose. The ex- 
tract should be given in pill form and continued for two 
weeks. This treatment prevents further trouble from 
colic, as a general thing. 



206 BLEEDING FROM THE EXTRACTION OF A TOOTH, 

BLEEDING FROM A CUT. 

When an artery is cut that lies close to a bone, it is 
unnecessary to tie it, as the bleeding can be stopped in a 
minute by pressure, so as to compress the artery against 
the bone. If on the foot, a half dozen folds of muslin, 
making a little firm compress an inch square or a little 
more, should be placed over the cut, and of course it 
must be large enough to cover it. Then a bandage is 
passed round the foot, commencing at the toes. It should 
extend to the ankle and bear firmly upon the compress 
covering the bleeding vessel. The bleeding can be stopped 
instantly in this way if the bandage and compress are 
properly applied. 

If the wounded blood-vessel is not close to a bone, cot- 
ton batting should be dipped in a solution of subsulphate 
of iron until it is soaking wet, and then forced into the 
wound and firmly held there with the fingers, until the 
bleeding is stopped or until a doctor arrives to take charge 
of the case. 



BLEEDING FROM THE EXTRACTION OF A 

TOOTH. 

Many cases of fatal hemorrhage have been reported 
within the last quarter of a century from the extraction of 
teeth. Many other persons have experienced great an- 
noyance from bleeding that could not be arrested for 
twenty-four hours or more after parting with a distressing 
toothache through the application of " cold steel." Either 
of the following methods will stop such bleeding in a few 
minutes, if properly used : If convenient, examine the 



BLEEDING OF THE NOSE. 207 

tooth that has been extracted so as to see the size of the 
opening in the jaw. Then select a vial cork large enough 
to fit into this opening, and if necessary cut off the top of 
it, so when it is forced into the jaw it will not project above 
the gum quite as much as the teeth do. Next soak it in a 
solution of subsulphate of iron, and crowd it down firmly 
into the cavity left by removing the tooth. The hemor- 
rhage will be arrested in a few minutes, if not instantly, 
and the cork may be allowed to remain for several hours. 
The other method is equally successful and is as follows : 
Take an ordinary hypodermic syringe with a point almost 
at right angles. Draw into the syringe three drops of 
solution of subsulphate of iron, then screw the point on. 
Wipe the bleeding gum perfectly dry with a small sponge, 
and as soon as a fresh drop of blood springs up, push the 
hypodermic needle into the exact spot from which the 
blood started and inject two or three drops of the solu- 
tion. It will curdle the blood instantly and stop the 
bleeding. 

The cork, if properly applied, will stop the bleeding in 
almost every case, even if not dipped in the iron solution 
at all. If no cork of suitable size can be found, a larger 
one may be dressed down with a sharp knife. A plug of 
soft wood, if whittled down to the right size to fit the 
opening in the jaw, will answer. 

BLEEDING OF THE NOSE. 

Another name : epistaxis. 

There are many persons in whom there is a peculiar 
tendency to hemorrhage, and in all such patients slight 
wounds upon the body, the extraction of a tooth', or a 



208 BLEEDING OF THE NOSE. 

" bump " on the nose may cause an alarming flow of 
blood. 

Bleeding of the nose may be due to congestion of the 
brain, a condition in which there is usually a fulness of 
the blood-vessels about the head; it may arise from en- 
largement of the heart, causing blood to be thrown with 
such force as to rupture the small arteries of the nose and 
its membranes, or it may result from disease of the blood- 
vessels. 

Termination. — Although many cases of bleeding from 
the nose have ended fatally, all such hemorrhages, if the 
proper treatment is employed, can be easily and promptly 
arrested. 

Treatment. — When due to congestion or inflammation 
of the brain, cold water should be applied to the head very 
freely for fifteen or twenty minutes. If this does not 
succeed in stopping the bleeding within a half hour, the 
following plan must be substituted for the cold water : In 
the first place, turn two ounces of solution of subsulphate 
of iron into a teacup. Then get a half-dozen slender chicken 
feathers about three inches long, from the inner side of a 
chicken's wing. They are not to be the quill-feathers of 
the wing, but the small straight ones that cover the roots 
of the main wing-feathers. The straightest and best ones 
should be selected whether found on the inside or outside 
of the wing. 

They should be tolerably stiff and firm. Dip one of 
them into the solution in the teacup so as to get all of its 
feathers soaking wet. Then quickly pass it into the 
nostril that is bleeding, and let an inch of the quill end 
stick out. Dip another into the solution in the same way, 
and push it into the nostril as far as it will go, and do it 



SORE LIPS. 209 

quickly, or a clot will form so you cannot pass it at all. 
These feathers are to be pushed in until there is no more 
room in the nostril for another feather. If there is bleed- 
ing from both nostrils at the same time, both must be 
treated in the same way. It will arrest the hemorrhage in 
a few minutes, as the writer has been using the treatment 
for a quarter of a century and has never known it to fail 
in a single case. After the feathers are all in and the 
bleeding stopped, the ends may be clipped off with scissors 
to within a half inch of the nose. 

In a day or two the formation of mucus in the nose will 
loosen all the feathers so they can be easily pulled out. 

This treatment is to be employed in all cases of bleed- 
ing from the nose that fail to yield to the ordinary 
remedies. 

SORE LIPS. 

This is an affection of the lips with which almost every 
one is to some extent familiar. Such sores are generally 
known by the very familiar term of " cold sores," as they 
are supposed to arise from common "colds." 

In most cases they do not arise from " colds " at all, but 
are due to errors in diet, or to eating too much rich food, 
such as fat turkey. The sores as a general thing are first 
seen in the morning, and are beneath the mucous mem- 
brane of the lip in little lumps sometimes as large as a 
pea or soup bean. If allowed to break out, they become 
sore and distressing, disfiguring the mouth for about a 
week. Some very pretty ladies are frequently ruined for 
a week or two at a time by such unsightly sores upon 
their lips. 

Treatment. — The free application of alcohol to the 



210 CRAMP COLIC. 

inflamed lips as soon as the sores begin to make their 
appearance, and repeated four or five times during the 
day and twice during the night, will always dry up the 
inflamed part and prevent breaking out. This treatment 
seems to be absolutely sure if carefully carried out, and 
therefore it is not necessary for any one, understanding 
the treatment, to suffer from raw, inflamed, and bleeding 
lips. When the swelling is first observed, the alcohol 
must be freely applied, and it ought to be repeated about 
every two hours during the day. If no alcohol is in the 
house, spirits of camphor may be used instead. 

CRAMP COLIC. 

This is an affection that comes on periodically, as a 
general thing, and yet the paroxysms are not always regu- 
lar in returning. Some persons may have the attacks a 
dozen times per year, while others may not have more 
than half that many in the same length of time. 

Symptoms. — Sometimes the violent paroxysms of cramp 
colic are preceded by warning symptoms, such as tran- 
sient pains in the bowels, or a distressed feeling after 
meals, attended frequently with headache. Such symp- 
toms often precede the regular attack a few days. Fre- 
quently, however, cramp colic breaks out in the night 
without any warning whatever, and is usually brought on 
in such cases by eating too much or partaking of some- 
thing very hard to digest. 

The pain is severe to commence with, and rapidly in- 
creases until the cramp or spasm of the abdominal mus- 
cles sets in. Then there is a terrible feeling of constriction 
as if the stomach and bowels were being squeezed by some 



CRAMP COLIC. 211 

powerful force, the patient screams and groans and great 
drops of perspiration stand upon the face. As a rule, 
there is no amount of heat in the form of poultices or 
towels dipped in hot water, that will assuage the terrible 
pain, and it is always best to resort to other and quicker 
means for relief. 

Treatment. — The treatment consists, first, in giving 
something for immediate relief, and second, to put the 
patient upon a regular course of treatment that will pre- 
vent the return of the paroxysms. For immediate relief 
there is nothing so good as a full dose of morphine, and 
in almost all cases it is better to give from a quarter to a 
half grain at a single dose. If the patient is large and 
strong, whether male or female, a half-grain dose of mor- 
phine will not be too much. There is nothing counter- 
acts the effect of morphine so thoroughly as pain, — the 
terribly excruciating pain of cramp colic, — and the cases 
that do not require a half-grain of the drug are few. It 
is frequently necessary, even when a half-grain is given, 
to follow it with another dose within an hour. 

After complete relief is afforded by the remedy, the 
paroxysm may be considered broken up. The next and 
most important thing to do, is to give such remedies as 
will prevent the return of the disease. Happily for all 
sufferers from this terrible affliction, there is a treatment 
given in another part of this book that seems to be abso- 
lutely sure to cure it, as the author has never known it to 
fail. The remedy is the extract of ignatia, and must be 
given just as directed in the treatment of " atonic dyspep- 
sia," to which the reader is referred. 

The drug should be taken for several months. 



212 GOITRE. 



GOITRE. 



Other names : " thick neck " ; bronchocele. 

The name by which this disease is most frequently 
known, is " thick neck," and consists of an enlargement 
of the thyroid gland. The tumor appears upon the throat 
just below the prominence known as "Adam's apple," and 
may be moderate in size so as to attract but little if any 
attention, or may be very large so as to cause serious de- 
formity. It is usually slow in its development, and is much 
more common in females than males. 

Treatment. — This consists in the prompt and regular 
application of the tincture of iodine to every part of the 
enlarged gland. The drug thus applied has a powerful 
effect upon the tumor, and will almost always cause its 
absorption within a few weeks if commenced soon after it 
makes its appearance. 

If the enlarged gland is neglected for several years, 
during which it is allowed to develop into an unsightly 
tumor, it is liable to become hardened or cartilaginous, 
and consequently incurable. After it has passed into a 
cartilaginous state, iodine will not affect it, and it can be 
removed only by the surgeon's knife. All glandular en- 
largements, this one included, can be favorably affected 
with the tincture of iodine, if not entirely overcome, pro- 
vided they are treated when they are comparatively small. 
Then they are soft and easily removed by absorption. 

As soon as a goitre makes its appearance, it must be 
painted twice per day with tincture of iodine, covering 
every part of the enlargement and extending a little be- 
yond it in every direction. After it is applied for two or 
three days in this way, the cuticle will peel off. Then the 



ULCERATIVE SORE THROAT. 



213 



application should be discontinued for four or five days 
and commenced again. Meanwhile, iodide potassium 
should be given every day as follows : — 

Iodide potassium, one-half ounce, 
Simple syrup, one pint. 
Mix, and take a tablespoonful three times per day be- 
fore meals. 



ULCERATIVE SORE THROAT. 

This is an affection characterized by an ulcer, usually 
upon one of the tonsils or the soft palate, and unless due 
to syphilis or consumption, is generally acute, and does not 
extend to the air passages so as to seriously affect the voice. 

Treatment. — All such ulcers occurring in strong, healthy 
persons can be cured in forty-eight hours or less time, as 
follows : Place in the bottom of a teacup the strongest 
possible solution of carbolic acid. Such a solution will only 
contain five per cent of water. Then take a soft swab 
and carefully clean the ulcer, but do not make it bleed. 
After this is done, dip the rounded end of a common lead 
pencil into the solution of carbolic acid, and with it touch 
every part of the ulcer so as to turn it perfectly white. The 
solution should only wet the end of the pencil that is 
rounded off with a knife especially for the purpose, and 
then there will be but little danger of burning the tongue 
or any other part of the mouth. If this is properly done 
the ulcer will heal in a day or two. The second applica- 
tion of the remedy is rarely necessary. Ulcers occurring 
on other parts of the body, if not due to syphilis, can be 
healed in the same way, as a general thing. In cases of 
scrofula there is a low state of vitality as a rule, with a dis- 



214 CHRONIC NASAL CATARRH. 

position of all ulcers to spread ; in such cases the carbolic 
acid does more harm than good. All ulcers found about 
the eyes must be let "beautifully alone" until an oculist 
or experienced physician can attend to them. 

ENLARGED TONSILS. 

This disease usually commences in childhood, and is 
mainly due to a succession of " colds " and a chronic sore 
throat. In such cases the tonsils sometimes become so large 
as to make breathing more or less difficult. For many 
years the writer adopted the popular plan of removing a por- 
tion of such tonsils with the tonsilotome or a suitable knife. 

Treatment. — In almost all cases the absorption of en- 
larged tonsils can be effected by rubbing them once per 
day with a crystal of sulphate of copper, which is usually 
known by the name of " blue vitriol." The crystal can be 
dressed, notched like the flint of an Indian's arrow, and 
tied in the end of a split stick, so there is no danger of its 
falling out in the throat while being used. The treatment 
in this way should be kept up for three months, as it only 
takes a minute every morning. Sometimes a crystal of 
alum acts equally well. 

CHRONIC NASAL CATARRH. 

Other names : catarrh ; chronic coryza. 

This is a chronic inflammation affecting the mucous 
membrane of all the passages of the nose, usually causing 
chronic swelling of these membranes and an increased flow 
of mucus. It may be attended with an impaired sense of 
smell and partial loss of hearing. 



CHRONIC NASAL CATARRH. 21 5 

Causes. — It is mostly due to frequent attacks of the 
acute variety. It is also caused by irritating drug powders 
and vapors. Syphilis is among the frequent and persis- 
tent causes of the affection. 

Symptoms. — The most marked symptom is an increase 
in the amount of mucus discharged from the nostrils. As 
the disease develops, the mucus gradually increases in 
quantity, and running down into the throat causes frequent 
paroxysms of " hawking," especially in the morning. 

The senses of smell and hearing are liable to be both im- 
paired, the former by an inflamed condition of the mem- 
brane in which the sense of smell resides, and the latter by 
closing tubes connected with the internal ear. 

Any changes calculated to cause a common cold, precipi- 
tates an acute attack. The inflammation often involves the 
tear duct, so as to close it in one or both eyes. In such 
case the lachrymal secretion, commonly called " tears," 
overflows, and the patient seems to be in a state of constant 
weeping. This is greatly aggravated by the chilly winds 
of winter. 

Termination. — If properly treated and the treatment 
continued for a sufficient length of time, the great majority 
of cases ought to be permanently cured. 

Treatment. — The author takes the position, and his 
opinion is based on extensive experience, that nasal catarrh 
is almost always a constitutional disease, and cannot be 
cured nor permanently benefited by a local remedy. 
Therefore the rational course to pursue is to find out what 
the disease is, as the trouble in the nose passages is not the 
disease at all, but simply the local expression of a constitu- 
tional affection. It is doubtful if the irritating influences 
that develop common catarrh would ever bring on that so- 



2l6 CHRONIC NASAL CATARRH. 

called disease if it were not for coexisting scrofula or 
some other form of blood contamination ; therefore, the 
treatment must be from the first, general and constitutional 
instead of local, as the latter at best is only palliative. If a 
sore or ulcer exist on any part of the body and will not heal 
of itself, or by proper treatment locally, it is evident that 
the trouble is constitutional. The same theory applies to 
catarrh, as it is rarely cured by sprays, douches, and snuffs. 

The following, if given for a sufficient length of time, 
will cure almost all cases : — 

Iodide of potassium, two drachms, 
Compound syrup of stillingia, one pint. 

Mix, and give a dessert-spoonful three times a day. 
When this remedy is given for four or five days, all the 
catarrhal symptoms are aggravated, the flow from the 
nostrils is increased, the tenderness of the membranes is 
greater, and there is usually sneezing, as if the patient had 
taken cold. In such cases, it is best to leave the remedy 
off for a couple of days and then give it in teaspoonful 
doses. It will probably increase the difficulty, even in the 
reduced dose, but not to any great extent. The fact that 
it does aggravate the symptoms proves that it is the proper 
remedy, and affords strong hope that it will ultimately 
cure. After it is given for a number of weeks in tea- 
spoonful doses, it will cease to aggravate the affection by 
the system becoming accustomed to the drug. Then it may 
be gradually increased to a half tablespoonf ul, or a dessert- 
spoonful, which is the same thing, and continued for six 
months. This remedy sometimes causes a little sore 
throat when taken for a long time or in too large doses. 
When it does this, it should be left off for four or five days. 
When it is given for a long time in small doses, as above 



ACUTE ARTICULAR RHEUMATISM. 2\J 

recommended, it is a sovereign balm for chronic catarrh ; 
but, unfortunately, the great majority of patients will leave 
it off after a few weeks, saying " It made me worse." 
Special attention is called to this feature of the remedy : 
It always aggravates the case, and this is the greatest proof 
that it will finally cure. As local treatments of every kind, 
given with a hope of cure, are a useless waste of time, 
none are recommended except the following, which seems 
to be the simplest and one of the very best : Snuff rich 
milk up the nose a half-dozen times a day. It accomplishes 
a great deal in relieving the irritated membranes, as the 
milk on evaporating leaves a thin, protecting film that 
shields the inflamed surfaces from the air. It is important 
to remember that deafness, resulting from existing catarrh, 
is greatly relieved, if not entirely cured, when the catarrhal 
inflammation permanently subsides under this treatment. 
As the deafness is usually caused by swelling of tubes in 
the throat that connect with each ear, the iodide potassium 
is strongly indicated to stimulate absorption and get rid of 
the swelling. 

ACUTE ARTICULAR RHEUMATISM. 

Other names : inflammatory rheumatism ; rheumatic 
fever. 

This is an acute constitutional disease, attended by inflam- 
mation around the joints, and commences with fever, the 
latter being high or moderate, according to the character 
and extent of the inflammation. 

Causes. — The predisposing causes are largely hereditary. 
The exciting causes are exposures to wet and cold. 

Symptoms. — The disease usually begins abruptly with 



218 ACUTE ARTICULAR RHEUMATISM. 

a chill, or chilliness, swelling and stiffness of the joints, 
intense pain, loss of appetite, and a hot fever, the tempera- 
ture reaching sometimes the extreme limit of inflammatory 
affections, or one hundred and ten. Tl>e pulse is not 
correspondingly rapid, seldom reaching one hundred per 
minute in adults. The urine has a sour smell, character- 
istic of rheumatism, and the bowels are constipated. The 
fever continues throughout the attack, subject to remis- 
sions. As there is no possible chance for mistake in recog- 
nizing this disease after a person has once seen a case of 
rheumatism, it is unnecessary to give all the symptoms. 

Termination. — The mortality is very low, as there are 
only three or four deaths in a hundred cases, and those 
are usually due to heart affections. 

Treatment. — Twenty years ago this was considered an 
incurable disease, so far as remedies were concerned, but 
was regarded self-limited, running its course in six or eight 
weeks. A knowledge of these facts caused an eminent 
physician to give v an amusing but painfully unsatisfactory 
answer to one of his patients. The patient said, " Doctor, 
what is the surest cure for rheumatism ? " The doctor 
answered, " Six weeks." The idea became so thoroughly 
engrafted in the minds of physicians that the term of six 
weeks was necessary for the cure of rheumatism, that years 
and years went by, during which but little effort was made 
to find a new remedy for the most distressing affection that 
afflicts mankind, and to-day there are thousands of doctors 
who believe that the " do-nothing " treatment is as good as 
any. 

The author has had an extensive experience with acute 
inflammatory rheumatism, and radically dissents from this 
view of the case, believing that there is a drug treatment, 



ACUTE ARTICULAR RHEUMATISM. 219 

when properly conjoined with hygienic measures, that is 
almost infallible in the severest and most acute cases. 
The drug treatment to be hereafter given depends for its 
success upon other things that are almost as necessary 
as the drug itself. If the patient has all the symptoms of 
the most violent form of rheumatism, he must be put in 
bed, between heavy blankets, whether it is winter or sum- 
mer, and made uncomfortably hot by a superabundance of 
bedclothing. The object of this is to encourage copious 
perspiration, and this should be further promoted by all 
the cold water the patient can drink. If he can drink a 
pint every hour it is all the better. In addition to this, 
give the following as directed : — 

Salicylate of soda, two drachms, 
Water, four ounces. 
Mix, and give a teaspoonful every half hour for twelve 
hours, after which give it every hour until it is all given. 
This is for adults, and if required for children must be re- 
duced accordingly. In the great majority of cases the 
pain, fever, and swelling will rapidly decline, and the 
disease is often brought under absolute subjection within 
twenty-four hours. To assist this treatment, however, 
remedies must he given to act on the kidneys, and carry 
out of the blood those salts that are supposed to be the 
main cause of rheumatism. 

For this purpose the following is probably the best 
remedy that can be given : — 

Sweet spirits of nitre, two ounces, 

Acetate of potash, one-half ounce, 

Water, 

Simple syrup, of each, one ounce. 
Mix, and give a teaspoonful every three hours. 



220 ACUTE ARTICULAR RHEUMATISM. 

If the bowels are bound, they should be moved freely 
with the following : — 

Epsom salts, two ounces, 
Cream of tartar, two ounces. 

Mix thoroughly, and give a heaping tablespoonful in a 
glass of water. This dose may be repeated in ten or 
twelve hours, the object being to get watery discharges 
from the bowels. 

In the practice of medicine total failures often occur 
from the neglect of little things, of things seemingly un- 
important, and this is why salicylate of soda, as it is usually 
given, often does but little good. Instead of giving it in 
divided doses every half hour, it is usually given in heroic 
doses every three or four hours. In this way an unneces- 
sary drug effect is obtained when only a drug effect upon 
the blood is desirable. When given every four hours, 
fifteen grains is the usual dose. When given every half 
hour as herein directed, the dose is about four grains, 
which means thirty-two grains in four hours, or about twice 
as much per hour as would be given by large doses. The 
remedy is not given to act on any special organ, but to 
sweeten and change the character of the blood that is 
always sour in rheumatism. While this is being done with 
a chemical, the poison in the blood is largely diluted by 
copious draughts of cold water. The patient is covered 
up with blankets, and is practically in the hot room of a 
Turkish bath-house. In this way, every one of the sweat 
glands — and there are millions of them — is stimulated to 
its utmost, and water pours out through every inch of skin. 
Meanwhile the kidneys are carrying off water, and in 
twenty-four hours the watery portion of the blood is almost 
entirely changed. Salicylate of soda is frequently given 



MUSCULAR RHEUMATISM. 221 

to patients that are out in the open air and trying to 
attend to business. It is practically worthless when given 
in this way. 

When patients have had one attack of rheumatism, they 
are liable to another, and should always keep their bodies 
warm with heavy flannels from head to foot. 

MUSCULAR RHEUMATISM. 

This disease has a number of other names, according 
to the part of the body in which it is located. 

Torticollis is a form of the disease affecting the muscles 
of the neck, and signifies a wry neck, or stiff neck. It is 
usually on one side, and the head is always inclined 
towards the affected side. In such cases an attempt to 
turn the head or straighten the neck is attended with great 
pain. 

Cephalodynia is a name given to a form of the disease 
affecting the frontal muscles and back muscles of the head. 
In this form the muscles of the eyes may be affected so 
that movements of those organs will excite great pain. 

Pleurodynia is the form of muscular rheumatism involv- 
ing the thoracic muscles, or the muscles of the chest, and 
is often mistaken for pleurisy, or neuralgia of that region. 

Lumbago, which is also called lumbodynia, is a form of 
the disease attacking the muscles of the lower part of the 
back. This is by far the most common form of muscular 
rheumatism, and probably the most distressing. 

Termination. — This is always favorable so far as life is 
concerned, as it is unattended with heart affection and 
never results fatally. 

Treatment. — In all inflammatory affections, rest is one 



222 MUSCULAR RHEUMATISM. 

of the most important features of the treatment, as motion 
causes pain, and whatever causes pain increases the in- 
flammatory condition. 

Muscular rheumatism is one of the most obstinate diffi- 
culties that ever confronts a physician. As in all other 
diseases that are incurable by a drug treatment, a multipli- 
city of remedies are given in the text books for this. 

The author has gone through the entire list time and 
again, and is compelled to acknowledge he has never found 
a remedy that exercised any curative effect upon the 
disease. It is considered unnecessary to give a list of the 
drugs usually employed in the various forms of muscular 
rheumatism, as they all seem to be worthless. Within 
recent years, however, the bromide of lithium has come to 
the front as a sovereign balm in the affection. It is claimed 
on very high authority to be a specific. It is given in 
twenty-grain doses, four or five times in twenty-four hours, 
and in extreme cases, the dose may be increased to thirty 
grains. Each dose should be given in a half glass of 
water. 

So far as the old remedies are concerned, the hygienic 
treatment is twenty times better than all of them. As 
lumbago is the worst and most frequent form, the treat- 
ment aside from the use of drugs is carefully given, and 
consists in wearing a heavy flannel pad around the entire 
body, extending from the middle of the back to the 
lower part of the spine. This excludes the air from the 
surface and favors rapid recovery. As persons who have 
had this trouble once are very liable to have it again, it is 
best to wear the flannel all the time in cold weather. If 
woollen irritates the skin too much, canton flannel may be 
used in its place. 



JAUNDICE. 223 

JAUNDICE. 

Other names : catarrh of the bile ducts ; catarrhal 
jaundice. 

This is an acute inflammation of the mucous membrane 
of the bile ducts, and also of that part of the small 
intestines called the duodenum. It is attended with 
derangement of the stomach and bowels, the skin is 
yellow, itches terribly, and there is mild fever. 

Causes. — Excessive eating is the most frequent cause. 
Malarial influences also develop the affection, but in such 
cases it is very chronic, or much less abrupt in its 
commencement. 

Symptoms. — It begins with distress at the pit of the 
stomach, the tongue is coated, appetite usually lost, 
sickness of the stomach, and sometimes vomiting. The 
bowels are generally loose, and there is mild fever. In 
four or five days the eyes become yellow, and a jaundiced 
condition spreads over the whole body. The skin becomes 
dry and itches continually ; the bowels are bound, stools 
usually very light in color, showing the absence of bile, 
there are pains in the bowels as if from colic, and the 
urine is unusually dark. 

Termination. — This is almost always favorable. 

Treatment. — The patient should rest quietly in bed or 
in an easy-chair, and be put upon a generous and unirri- 
tating diet. The inflammatory condition of the small 
intestine is best met by small doses of mercury, given as 
follows : Mercurius dulcis, the first decimal trituration, 
twenty-five grains. Divide into five powders, and give 
one powder every hour, placing each powder on the 
tongue in a dry state, and giving a swallow of water to 



224 ACUTE NASAL CATARRH. 

wash it down. As the powders work off, the stools will 
change from a light clay color to a dark brown, finally 
becoming natural. The drug acts both on the bowels and 
the liver, and usually places the patient on the road to 
recovery ; but the kidneys must be stimulated in order to 
get rid of the bile with which the blood is heavily loaded, 
and which is causing the intense itching, and which, 
sooner or later, must give rise to bilious sores over the 
body. The best remedy for this purpose is the fol- 
lowing : — 

Sweet spirits of nitre, two ounces, 
Acetate of potash, a half ounce, 
Water, two ounces. 

Mix, and give a teaspoonful every three hours in 
sweetened water. 

Under this treatment, the urine will become very highly 
colored, and the yellow will fade rapidly from the eyes 
and skin. 

ACUTE NASAL CATARRH. 

Other names : " cold in the head ; " acute coryza. 

This is an acute inflammation of all the membranes of 
the nose and those directly connected with the cavities of 
that organ, and is attended with fever, more or less distress 
in the head, and a discharge of watery mucus from the 
nostrils. 

Causes. — Changes in the direction and temperature of 
the air are the most common causes. Sitting -in a draught 
of air, whether it is particularly cold or not, is a frequent 
cause. Exposing the feet to cold and wet, or a changing 
from warm apartments to cold ones, often brings on an 
attack of "cold in the head." Irritating vapors and the 



ACUTE NASAL CATARRH. 225 

dust of certain drugs produce all the symptoms of com- 
mon cold. The most noted one of these is turpentine. 
Where it is used in inside painting, its vapor affects the 
membranes lining the cavities of the nose in such a way 
as to produce all the symptoms of a violent cold. Pow- 
dered ipecac acts as an irritant to these membranes, and 
affects some druggists so they cannot handle it at all. 

The pollen, or fecundating dust of certain flowers acts 
as an irritant upon those who are peculiarly susceptible to 
it, affecting the membranes of the nose and eyes, produ- 
cing all the head symptoms belonging to a common cold ; 
but the attack is much more protracted, and is usually 
called "hay fever." 

Symptoms. — A "cold in the head" is often preceded 
by a dull, heavy feeling, with headache over the eyes, 
chilly sensations, and a tendency to sneeze. This is speed- 
ily followed by a flow of watery mucus from the nostrils, 
dripping in such a way as to render the constant use of 
the handkerchief necessary. The membranes of the nose 
are red and inflamed, and sooner or later the discharge 
changes from a watery mucus to a mixture of mucus and 
pus. In five or six days, however, recovery sets in, and 
the patient is well within eight or ten days. 

Termination. — This is favorable if properly treated from 
the commencement, but if neglected may drift into chronic 
catarrh. 

Treatment. — When this trouble arises from atmospheric 
changes, it may be broken up by eight grains of quinine, 
combined with twelve grains of Dover's powder, given at 
one dose. This is for an adult and not for a child. 

When the attack is fully developed, great relief may be 
obtained by giving the following : — 
Q 



226 GIN LIVER. 

Tincture of belladonna, ten drops, 

Water, twenty teaspoonfuls. 
Mix, and give a teaspoonful every hour for six hours, 
then give the same dose every two hours for six hours. 
If there is considerable fever, give the following at the 
same time, allowing the doses to fall between those of 
the belladonna : — 

Tincture of aconite, twelve drops, 

Water, twelve teaspoonfuls. 
Mix, and give a teaspoonful every hour until six doses 
are given, then leave it off for three hours, and if the fever 
is not overcome give a teaspoonful every hour until all is 
given. This dose is for adults. 

GIN LIVER. 

This is a chronic inflammation of the liver, with hard- 
ening of its substance and shrinking away of its secreting 
cells. There is a catarrhal irritation of the stomach and 
bowels, great loss of flesh, and finally abdominal dropsy. 

Causes. — It is almost wholly due to the prolonged use 
of alcohol in some form, or, in other words, to intoxicating 
liquors. 

Symptoms. — In the early stage of the disease, the 
symptoms are not strongly defined, but when a constant 
irritation of the stomach and bowels is attended with fre- 
quent attacks of jaundice, and the patient is an intemper- 
ate man, it is safe to infer that he has a " gin liver." As 
hardening of the liver offers an obstruction to the circula- 
tion in the organ, the blood is checked in returning from 
the lower part of the body to the right side of the heart, 
giving rise to abdominal dropsy, and causing enlargement 



GOUT. 227 

of all the veins below the heart, and especially those about 
the anus, and when these latter are very large the condi- 
tion is known as piles. The affection is further character- 
ized by dyspepsia, pain in the bowels, hemorrhages from 
the stomach or bowels, due to engorgement of the veins. 

Termination. — This is always unfavorable, and a man 
generally dies within a year from the time the dropsy 
makes its appearance. 

Treatment. — As the disease is always due to a perma- 
nently hardened condition of the liver, attended with a 
withered or shrunken state of the secreting cells, there is 
no remedy that can exercise any curative power whatever 
upon the malady, and to attempt to accomplish anything 
except temporary relief of the patient's sufferings, is a 
useless waste of time. 



GOUT. 

This is a constitutional affection, the tendency to the 
disease usually being inherited, and is attended with par- 
oxysms of severe pain and swelling of one of the smaller 
joints, frequently that of the "big toe." There are often 
deposits of the urate of soda in the joints of the fingers. 

Causes. — The predisposing causes are inherited. 

The exciting causes are intemperance in eating and 
drinking. Cold weather may also be an exciting cause. 

Symptoms. — The disease occurs in paroxysms, a period 
of one year usually intervening between the first and sec- 
ond attacks. The second and third attacks are liable to be 
within six months of each other. After this they may come 
very close together. 

Each attack is preceded two or three days with symptoms 



228 GOUT. 

of indigestion. The paroxysm almost always begins in 
the night with severe pain in the big toe which rapidly 
becomes inflamed and tender. 

The foot, ankle, and leg become greatly swollen. The 
attack may be preceded by a chill, fever, rapid pulse, thirst, 
and all other symptoms attending an acute inflammation. 
By morning the severe symptoms subside to come on again 
about sundown, the disease gradually falling off in inten- 
sity until the fifth or sixth day when recovery is established. 

In the chronic form of the disease the symptoms are all 
less severe than in the acute, and the deposits of chalk- 
stones are seen about the joints. 

Termination. — This is almost always favorable as far as 
life is concerned, but the malady is liable to return unless 
the greatest care in reference to diet and the use of liquors 
is observed. 

Treatment. — The best remedy for the acute form is the 
following : — 

Salicylate of soda, two drachms, 
Water, four ounces. 

Mix, and give a teaspoonful every hour, meanwhile 
keeping the patient covered up with blankets. 

This should be continued for twenty-four hours and may 
be expected to relieve greatly the inflammation. The 
pain may be controlled by the use of morphine in quarter- 
grain doses every hour until the patient is reasonably com- 
fortable. A rich meat diet should be avoided and milk and 
soups used instead. 

In the chronic form of the disease, iodide of potassium 
is the best remedy and may be given as follows : — 
Iodide potassium, three drachms, 
Water, eight ounces, 
Simple syrup, four ounces. 



HEREDITY AND HEREDITARY INFLUENCES. 229 

Mix ; dose, a dessert-spoonful four times a day. 

In chronic gout the diet is of the utmost importance and 
should consist, mainly, of fruits and vegetables. Stimu- 
lants of every kind, including tea and coffee, should be 
dropped ; pastry of every kind and eggs in every form do 
harm. Heavy flannel underclothing in cold weather is of 
the utmost importance. 

HEREDITY AND HEREDITARY INFLUENCES. 

This is a subject that every one knows something 
about, but that very few know much of. It has been 
a current quotation for many generations that the sins of 
the fathers were visited upon the children to the third and 
fourth generations, but the book out of which the quota- 
tion is taken does not say much if anything about the 
effect of the sins of the mothers on the offspring. In 
fact, the mothers did not amount to much in the literature, 
nor in the religion, of the day in which the language is 
supposed to have been written. The discussion of hered- 
ity belongs to social science, and should have a place in 
the schools beside arithmetic, geography, history, philoso- 
phy, and physiology. The exclusion of it from the com- 
mon schools and colleges, literary, medical, and religious, 
necessarily impresses the educated and the cultivated, as 
well as the ignorant, that it is of no great importance and 
is not a factor in human education. Authorities pretty 
well agree, now, that physical derangements and mental 
alienations are more commonly inherited from the mother 
than from the male parent. Especially is this so in the 
diseases of the mind. Insanity and the suicidal impulse 
are oftener communicated from the mother to the child, 
and oftener to the daughter than to the son. We notice 



230 HEREDITY AND HEREDITARY INFLUENCES. 

the following distinction is observable between man and 
the other animals in the matter of the transmission of 
physical qualities. In the former, the general structure 
of the body, the height, the degree of development of the 
bones and the muscles, the tendency to obesity, leanness, 
etc., seem to depend as frequently on one parent as on the 
other ; but in the dog, horse, and many other animals, the 
male ancestor more frequently determines the general 
form, size, and strength of the body. It requires but 
small effort of the mind to determine why the more ancient 
tribes of man placed so great estimate on, and gave such 
precedence to, the position of the man in the business of 
life over that of the female. In the near approach to 
crude and animal conditions of the race, the size, form, 
bony and muscular strength, were far more frequently 
communicated to the child by the father. These were the 
most important and dominant features of the individual 
when bodily strength was at a great premium, and when 
war with the wild beasts, with the elements, and with 
savage man constituted most of the exciting scenes of the 
times. It is a sad reflection that so many mothers become 
mentally alienated. They are compelled, with their refined 
and delicate nervous systems, to bear the strain of nursing 
and the care of the house affairs, often under poverty and 
privation, of which the world in its pomp and learning 
knows nothing. 

A French report, and they are an average nation, 
perhaps, says, that out of 467 cases of insanity, 279 were 
traceable to the mothers. It is still more lamentable that, 
where there is a taint of alienation in the mind of the 
mother, the daughters are much more liable to affections 
of the kind than the sons. 



HEREDITY AND HEREDITARY INFLUENCES. 23 1 

Whilst the father in the more primitive races imparted, 
quite uniformly, the physical qualities, so did the mother 
give to the child the refining influences of the delicate 
temperament, with the spiritual and the love of the beauti- 
ful more and more unfolded, as the race of man spread 
over the earth. Thus did man become the subduer, and 
woman the educator, of the world. Woman's refined and 
delicate temperament predisposes to insanity. This will 
not be the case when the race is more advanced, and when 
better and more suitable modes and conditions of life are 
provided for her. It is truly distressing that mothers 
are so liable to transfer insanity to their daughters, who 
are the prospective mothers of what it is hoped will be a 
better society than the present. But the disposition to 
disease of the nervous matter is manifested in various 
forms and in different members of the family. It may be 
insanity in one member of the family, and epilepsy in 
another, and mere eccentricity in another, and they may 
all be traceable to nervous affections in the mother. 

It is the usual custom of all the civilized countries for 
persons who come to maturity to take upon themselves 
the burdens of married life without any thorough investi- 
gation of the family history in reference to physical and 
mental affections of the person of their choice, and in 
case there appears insanity, epilepsy, or idiocy, as a rule 
they pay little, if any, attention to it. It is admitted to be 
true that, in the new family thus started, there may be a 
number of children born, and no serious deviation from 
health ever crop out to call the attention of the parents 
to the carelessness of their youth. But then, again, from 
physical inharmony in the father and mother, or from 
some local situations or misfortunes, aggravating or excit- 



232 HEREDITY AND HEREDITARY INFLUENCES. 

ing an inherited tendency, there may be a number of the 
offsprings of the union hopelessly diseased in mind or 
body, or in both. All diseased tendencies are inherited. 
If one man lives in a swamp and does not contract ague, 
whilst another beside him does, and shakes himself to 
death, it is not because the unfortunate one inherited the 
ague from his father or his mother, but it was on account 
of his not inheriting the same amount of vitality that his 
neighbor did, other things being equal. Should one man 
take a cold and cough a week or two, and then get well, 
and another contract a catarrh at the same time of, seem- 
ingly, no greater severity, and in the same house and under 
all the conditions and circumstances, and yet, should he 
continue to cough for months, and at last the doctor should 
decide that he had bronchitis or consumption, what would 
you say of such a case ? You would say that there was, 
presumably, greater hereditary tendency in the latter than 
in the former case, to lung disease. 

We make this general proposition: All diseases may 
and can be shunned and avoided in offspring by proper 
precautions in marriage, and in the habits of life. 

If the rule will hold good in one case it will hold in all. 
Some persons are so fraught in their lives with harmoni- 
ously distributed vitality, that they will not contract the 
contagious diseases. If we should resort to the law of the 
survival of the fittest, in marriage, it might be decried as 
cruel, yet it would not seem more heartless than to per- 
petuate, for thousands of generations, the diseases that 
have crept into the veins, arteries, bones, nerves, and the 
brain of the present fabric of society, and threaten to 
shake the human temple to its foundations. There is 
nothing more relentless than perverted nature, nothing 



HEREDITY AND HEREDITARY INFLUENCES. 233 

in the shape of an enemy to happiness, more uncompro- 
mising and awful, than the arrested processes of the pure 
springs and currents of the life and soul. There is no 
happiness greater than that of the healthy and temperate 
father, clasping his son or daughter in his arms, and bless- 
ing each with a father's love. There is no person on earth 
more happy than he, unless it should be the mother with 
the warm and the rose-tinted cheek, surrounded by comfort 
and possessing a true and a loving husband, bestowing a 
mother's love upon her sons and her daughters to whom 
she has given the pure currents of life, and the thrill of 
an electric brain. It was once said that there was silence 
in heaven on a certain occasion, for a brief space of time. 
Might not the angels in the cloisters of the skies have 
laid down their implements of praise, and ceased their 
songs to gaze on a sight like this ? 

THE INFLUENCE OF HEREDITY ON LONGEVITY. 

It is not disputed that long life is inheritable. On the 
other hand, all seem to admit, with one accord, that great 
age in ancestors is a guarantee, more or less, to the de- 
scendants, of a long life. In this matter, however, many 
would-be students of nature have only the most general 
idea of how to proceed to gain information in any particu- 
lar case, as to his lease of life, his power to resist disease. 
A keen discretion in prognosis, an ability to weigh the 
vital powers at the time of a crucial test, at the climax of 
a term of illness, or at other times, is no mean qualification 
in a nurse or a physician. In writing a book to be the 
close companion of the fireside, the home, and the nursery, 
one should not withhold the key that unlocks the door to 
the chamber of the secret forces, and reveals the natal 



234 HEREDITY AND HEREDITARY INFLUENCES. 

and ante-natal sworded angel, to use a metaphor, standing 
guard to perpetuate the life of the patient. The life 
faculty is plainly shown in a certain location on the 
cranium, or the skull, one inch above and perpendicular 
to the large prominence immediately back of the ear. 
The degree of prominence in this locality invariably 
marks the power of endurance, the ability to resist dis- 
ease, and the strength of tendency to longevity, or length 
of the life. Children who recover from long and severe 
illness will, in almost all cases and instances, be found to 
measure wide between these two points described as being 
one inch above the prominence immediately back of the 
ears. If the head is narrow instead of wide here, there is 
less probability of long life and of recovery from disease, 
and this will be in proportion to the depression and lack 
of development. A person with a small head, say a man 
with a six and a half hat, might appear narrow, but if 
discrimination were used it might be easily determined 
whether or not there was fulness or depression. If you 
examine the heads of persons of from sixty to seventy 
years of age, and, especially if they are strong and 
sprightly, you will find this department of the brain 
rounded out, full, and, sometimes, projecting into almost 
a sharp protuberance. In running back in the ancestry 
of such persons you will always find that a number of 
the family have lived to a great age, but it is not always 
the case that it is the immediate ancestors, but may be the 
grandfather or the grandmother, on one side ; where the 
grandparents on both sides are long-lived there will be 
a greater number of the descendants having this faculty 
well outgrown. 



HEREDITY AND HEREDITARY INFLUENCES. 235 

MENTAL CHARACTERISTICS. 

If this pronounced tendency to the inheritance of traits 
in the physical character is an absolute and incontroverti- 
ble fact, which is easy of proof and demonstration, the 
same may be looked for in mental characteristics. And 
when we consider that this wonderful truth is established, 
beyond the possibility of a reasonable doubt, it then be- 
comes a duty to study the details of its operation upon the 
present and the future generations, and to diligently in- 
quire into the uses that we, as individuals, might make of 
the knowledge of it in hastening the answering of the 
petition of the prophet : " Lord, I beseech thee, show me 
thy glory." Our race has come up from crude conditions, 
through great tribulation. They have sought for the lamp 
of Aladdin, and in their sleep they have dreamed of Pan- 
doras, yet in their visions they have too seldom sighted 
' 'the true and the living way" that is to guide mankind 
in struggling up the steeps of time, that the gates of the 
ineffable may be opened to him, and that he may be able 
to help this old world ever grow brighter. 

There is this difference between the vitative faculty, and 
what is termed the vital temperament : The vital tempera- 
ment gives bounding of the blood and vigorous digestion, 
roundness of the limbs, and fulness of the cheeks ; whilst 
the vitative faculty may or may not be marked by these, 
yet is always connected with tenacity of life. In the vital 
temperament, the powers of the mind and the body may 
be vivacious until middle life, or some later, and then 
rapidly fail, whereas, in the case of the high prominence 
of the head in the location of the organ, there is likely to 
be a gradual growing and strengthening of the body and 



236 HEREDITY AND HEREDITARY INFLUENCES. 

of the mind, also, until a late period in the individual's 
years. 

INTELLECT AND SPIRITUALITY INHERI- 
TABLE. 

Spirituality and intellect are inherited. They are gifts 
that descend from parents to child, and when liberally 
bestowed, and practically outgrown, are conducive to 
health, long life, and happiness. 

Spirituality, as marked in the physical organ, is located 
on the top of the head, but toward the sides, and separated 
by another organ, and is half-way between the edge of the 
hair in front and the crown in the back, and, when well 
developed, gives broadness to the head in that region, from 
side to side. The intellectual embraces all that part of 
the head that is called the forehead. 

Man and other animals find their associates, employ- 
ments, activities, and pleasures, in their respective spheres 
of existence. It is hardly conceivable to one who is not 
endowed with literary tastes and abilities, how another can 
find pleasure in such gifts and pursuits. It is mortifying 
to read a splendid poem to a friend or a neighbor, and have 
him ask you for a chew of tobacco instead of offering 
a compliment on your manner of reading it, or of noticing 
some remarkable beauty in the verse. It is likewise very 
difficult, if not impossible, for one who is narrow in the 
region of the head designated as occupied by the spiritual 
sphere of the mind, to understand the uses and pleasures 
of this higher and acuter sense of the soul of man. It is 
well known that there are those who complain that divine 
providence has neglected to dispense to them the favored 



HEREDITY AND HEREDITARY INFLUENCES. 237 

gifts, and they have been heard to remark that it was 
strange that they could not be the possessors of such grand 
and noble talents. Parental love weeps over a child that is 
a monstrosity in form, or a failure in brain development, or 
diseased in a hopeless manner. So does a true humanitarian 
grieve to behold so many of our race deprived of the gifts 
that make life sublime, and thrill the hearts of men with 
song and music, and cause the canvas to speak to the living 
eyes, and the stone to utter words of praise to the infinite. 

There is no manner of use to state facts and print them 
in books, if they are not practised. If you look in the 
mirror and go your way and forget what manner of man 
you are, you have not profited by the performance. When 
we make the declaration, — the clear and positive statement, 
— that the spiritual function of the mind, the faculty that 
determines the probable length of life on the earth, by its 
greater or less development, the intellectual powers, and, 
indeed, all the instincts, appetites, and inclinations, are 
inherited, even the disposition to burn, murder, and poison, 
the generality of the people of the age may be poorly pre- 
pared to receive it. 

In view of this state of things existing among a large 
class of the population of the earth, many of the most 
delightful, and the most practical truths find their way to 
the understanding of men in much the same fashion as the 
light of the day reaches the inhabitants of the deep valley 
by struggling over the mountain peaks. Therefore, we 
are not writing for those who cannot or will not reason, 
except in the sense of trying to entice them into the path 
of unprejudiced thoughtfulness. We only mention these 
Godlike proclivities of the human creature, the intellectual 
and the spiritual, as qualities of descent from an earthly 



238 HEREDITY AND HEREDITARY INFLUENCES. 

parentage, to show their connection with the health and 
the physical life in their broader stages, and not to refer 
to them in a religious sense. 

EFFECTS OF EMOTIONS OF THE MIND OF 
THE MOTHER ON THE CHILD. 

Argument is not necessary to establish the fact that 
violent and excessive excitement of the mother's mind 
sometimes proves disastrous to the unborn infant in pro- 
ducing "marks," deformities, idiocy, epilepsy, etc. We 
remember once being acquainted with a family in which 
there were four idiots of different ages, some two years, 
running down from the first to the second, etc. None of 
them could articulate, and all walked backwards on the 
hands and the heels. It was all caused by the mother 
witnessing the fall of a man who was stunned to uncon- 
sciousness and afterwards crazed, by a fall. Another 
case which seemed certain of this kind of origin in an 
otherwise healthy family, was that of a young man of 
rather fine business talent and good mind, generally, who 
had epilepsy from the effect of the mother seeing a rat die 
with convulsions from strychnine poisoning. Many slight 
marks which point back to some taste or fancy of the mother 
before the birth of her child are somewhat amusing, but are 
no less confirmatory of the principle in question. 

These and many other instances that might be cited 
prove that through the soul and the life of the mother 
pass the influences which are to become as the brush of 
the artist and paint the character of the individual. But 
whilst the fact is easily discoverable when it takes a physi- 
cal turn, it requires more thought and attentive reasoning 



HEREDITY AND HEREDITARY INFLUENCES. 239 

from cause to effect when it comes to matters of the mind. 
It has been sufficiently demonstrated to clear away all 
doubt, that the mother, if favorably situated and so desires, 
may incubate her child to be a poet or a mathematician, or 
both. If she exercises her mind on these or any other 
subjects in a systematic way in the time of her pregnancy, 
she may safely calculate on results. A certain lady 
decided in her mind that she would like to have her child, 
who she imagined would be a son, a poet. 

The child was born in due time and the mother was 
disappointed in it not being a male child, but she was a 
rhymer all the same, and attained distinction in her writ- 
ings. The mother had read the standard poets, and had 
made some efforts herself in the direction of verse during 
the time of her term. We well know a family in the West 
who illustrates this feature of descent in a rather remark- 
able way. The young mother was absent from her hus- 
band and was lonely ; she would go out in the wild, deep 
woods and gaze on nature in her crude but bright and 
grand glories, and would draw pictures and designs in the 
sand on the shores of a stream, and would make sketches 
on the rocks. And often in these haunts of hers she would 
sing the rural ballads she had learned. The daughter 
early in her life took to landscape painting and trying to 
write verse, and went wild, almost, over music. We knew 
a family in which there were two sons, all the children of 
the marriage. The mother informed us that in the time 
of the uterine life of the first she loved and worshipped the 
husband, but with the younger she did not love him but 
hated him because she had found that he was false to her 
and was not worthy of her love. When the younger son 
was born he was diseased and hated his father as soon as 



240 HEREDITY AND HEREDITARY INFLUENCES. 

he was old enough to do so. The mother of the Pomeroy 
boy hated her husband and used to want to kill him when 
he was butchering the animals. The boy was a murderer 
at eight years old, and is in prison at the age of thirty or 
more on one of the islands near Boston. Napoleon Bona- 
parte was the greatest expression of military genius that 
ever lived. His mother accompanied her husband out on 
to the field, and witnessed the progress of battles previous 
to his birth. Among his first boyish performances was the 
arranging of mock men in lines of battle, and deploying 
them so as to take military advantages. Beethoven was a 
great musical composer. It is said of him that he received 
his wonderful talent from parental and maternal emotions. 
He composed sonatas at the age of thirteen, and in his 
last years, though deaf, he gave to the world specimens of 
musical art that can never die. 

But it is not so much to have produced the prodigies of 
genius nor the muscular marvels, that we urge attention to 
these great and living and practical truths, but more to fix 
upon the mind that the best inheritance one can leave is 
an ennobled and purified posterity. It is to urge the plea 
of abstinence from the use of stimulants and all excesses, 
even that intoxication of the mind that is often connected 
with business, going on from one degree of strain to an- 
other until the life is sapped and all source of happiness is 
crushed out. 

We urge attention to these matters, again, because the 
men and the women of the present are the custodians of 
the happiness of their successors in the oncoming ages 
of the world. Though your forms may sleep in the dust, 
blest in memory or not, according as you have lived, they 
will think through your brains and act through the physi- 



CONGESTION OF THE KIDNEYS. 24 1 

cal machinery of your lives. Do not be sick. Do not 
hand down to your sons and daughters shattered constitu- 
tions and poor vitality. Seek the best and the surest 
means of restoring health and preserving it, and remember 
that " common sense " is a splendid hygienic guide. 



CONGESTION OF THE KIDNEYS. 

Other names : catarrhal nephritis ; renal hyperaemia. 

Congestion of any organ always signifies an increased 
amount of blood in the blood-vessels of that organ. If 
the arteries are distended, as they sometimes are in con- 
gestion of the kidneys, the affection is termed an active 
congestion of the kidneys. If the veins only are dis- 
tended, it is called a passive congestion. Congestion of 
the kidneys, whether active or passive, is attended with 
pain and a frequent desire to urinate, the urine being 
scanty, high colored, and sometimes bloody. 

Causes. — The active form may arise from exposure to 
cold, or from taking irritating drugs, either by the mouth 
or by inhalation. One of the worst of all drugs in this 
respect is turpentine, and for this reason many persons 
cannot sit in a newly painted room in which turpentine 
has been used without experiencing great irritation of the 
kidneys. 

Passive congestion of the kidneys may be due to dis- 
eases of the heart, lungs, or liver, or to the condition of 
pregnancy. 

Symptoms. — In the active form there is pain over the 
kidneys, the bladder is irritable, with a continued desire to 
pass water, while the quantity is small and of course high 



242 DIABETES INSIPIDUS. 

colored. There is a slight fever, headache, more or less 
sickness of the stomach, and sometimes vomiting. 

Termination. — Usually favorable if properly treated. 

Treatment. — In dealing with all diseases, the most 
important thing to be done is to remove the cause. If 
the cause of this disease is irritating drugs, the urine 
should be diluted by drinking large quantities of water so 
as to weaken the effects of the drug and stop its irritation. 

The remedy that seems most applicable to both forms 
of the affection is digitalis, which may be given in ten- 
drop doses of the tincture, four or five times in twenty- 
four hours. 

The pain is best controlled by sulphate of morphine in 
one-fourth grain doses, two or three times in twenty-four 
hours. 

DIABETES INSIPIDUS. 

Other names : polyuria ; polydipsia. 

This is a disease characterized by the passage of large 
quantities of urine, without sugar or albumen. 

Causes. — More or less hereditary. A disease of child- 
hood or young persons, chiefly, and more liable to occur 
in men than in women. May be caused by drinking 
freely of cold water, or from chronic debility. 

Symptoms. — There are two principal symptoms that 
characterize this disease, and when always present are 
sufficient, in the absence of sugar in the urine, to deter- 
mine its character. The first is great and continued 
thirst. The second is the habitual discharge of an 
immense amount of urine, in which no sugar is found. 
Either attending the large flow of urine or preceding it, 
is a general derangement of the nervous system, attended 



DIABETES MELLITUS. 243 

with headache, irritability of temper, and loss of 
memory. 

Termination. — In reference to a radical cure, the result 
is not very favorable. If, however, the disease is due to 
syphilis or some other affection that is curable, the dia- 
betes will disappear on removal of the cause producing it. 
Treatment. — If syphilis is the cause, iodide potassium 
should be given in small doses for a long time, as follows : 
Iodide potassium, two drachms, 
Water and simple syrup, each a half pint. 
Mix ; dose, a teaspoonful three times a day. 
After it is given for a few months, the dose may be 
gradually reduced to a teaspoonful. At the same time 
the following may be given : — 

Corrosive sublimate, six grains, 
Water, one pint. 

Mix ; dose, a teaspoonful night and morning. 
This may be given during the whole time that the iodide 
of potassium is being taken. 

DIABETES MELLITUS. 

This is a chronic disease in which grape sugar is present 
in the urine, with a profuse urinary discharge, and a con- 
stant tendency to fall away in flesh and strength. 

Causes. — The tendency to the disease is often heredi- 
tary, it is most frequent in males, and occurs at all times 
of life, but mostly between thirty and fifty years. It is 
also due to diseases of the nervous system, involving the 
liver and kidneys. Starchy food and liquors are also 
exciting causes. 

Symptoms. — Urination is much oftener than in health, 



244 DIABETES MELLITUS. 

and the amount of water passed is increased, while there 
is pain in the region of the kidneys. 

The amount of urine passed in twenty-four hours may 
range from a half gallon to three or four gallons. The 
amount of sugar in the urine is very great, and if a little 
of it is spread on a piece of paper in the summer time, it 
will attract the flies as readily as if it were table syrup. 
Another easy way to get an idea of the amount of sugar 
contained in a sample of urine is to pour some of it in a 
broad, flat dish, cover it over with netting to keep the flies 
out, and allow it to evaporate in the sun and air. When 
the water is all gone a thick syrup or dry sugar will be 
found on the bottom of the dish. 

Sugar in the urine causes itching and burning along the 
urethra and at the neck of the bladder. In females it 
causes itching of the external sexual organs. 

One of the most notable symptoms of diabetes is a thirst 
that nothing will allay. The most frequent group of symp- 
toms are those of dyspepsia. The bowels are generally 
constipated, and the stools are light colored. The pro- 
gressive loss of flesh is the most frequent and alarming 
symptom. 

Termination. — This is decidedly unfavorable so far as 
a cure is concerned, and in the great majority of cases' a 
fatal termination is reached within a few years. 

Treatment. — In the line of drugs nothing has ever been 
found to exercise a curative influence upon the disease. 
In other words, no drugs are known that will cure dia- 
betes, and therefore the treatment is almost wholly one of 
diet. As the morbid conditions consist of an abundance 
of sugar in the urine, all articles of food calculated to pro- 
duce sugar must be left off, and these include sugar itself, 



GALL STONES. 245 

and all fruits and other articles of food containing sugar, 
and all starchy articles, such as bread, potatoes, peas, rice, 
beans, oatmeal, cracked wheat, and corn. The diet must 
be almost wholly animal food. 

Tea, coffee, and milk may be used at the table without 
sugar. 

A drug treatment of any kind can do but little if any 
good, except to relieve symptoms. Where the nervous 
disorder is of a character to prevent sleep, and this is fre- 
quently the case, sulphonal is probably the best remedy, 
and ten grains, either in tablet or powder, given every 
night at bedtime, may be sufficient for months to secure 
for the patient refreshing sleep. In time, however, the 
dose will have to be increased to fifteen grains, and finally, 
thirty or forty grains may have to be given, but such cases 
are rare. 

GALL STONES. 

Other names : hepatic colic ; hepatic calculi ; biliary 
calculi. 

This affection consists of biliary deposits, either in the 
gall-bladder or bile-ducts. Whenever one of these de- 
posits or gall stones passes into the duct leading to the 
bowels, the walls of that duct are stretched and sometimes 
lacerated, causing in either case great pain, which is com- 
monly called bilious colic. 

Symptoms. — Hepatic colic commences with the first 
.attempt of a gall stone to pass along the bile-duct, and 
therefore as soon as the stone leaves the gall-bladder the 
colic, with all its agonizing pain, begins, the seat of the 
gall-bladder being the focus of distress. The muscles of 
the abdomen are sore, there is sickness of the stomach and 



246 ACUTE BRIGHT'S DISEASE. 

vomiting, pulse feeble, skin pale. The paroxysm may con- 
tinue for several days, remissions of the distress usually 
occurring, the pain finally ceasing when the stone reaches 
the bowel. When the stone reaches the intestines, all the 
distressing symptoms suddenly subside and the jaundice 
begins to fade. 

Termination. — This is usually favorable, but if the stone 
is too large to pass through the bile-duct and enter the 
bowel, an abscess must be formed in the duct, allowing 
the stone to escape into the abdominal cavity outside of 
the bowel, causing fatal inflammation. 

Treatment. — As the pain attending the passage of a 
gall stone is one of the very severest that afflict mankind, 
the dose of any remedy calculated to relieve such pain 
must be very large, and therefore a half grain of the sul- 
phate of morphine may be given at one dose, and repeated 
when necessary. 

The application of heat by the use of cloths dipped in 
hot water, if placed over the liver, may do a great deal 
of good in relaxing the gall-duct and allowing the stone to 
pass. 

ACUTE BRIGHT'S DISEASE. 

Another name: inflammation of the tubes of the 
kidneys. 

This is an acute inflammatory affection of the lining 
membrane of the tubes of the kidneys, and is attended by 
fever, high-colored urine, more or less turbid or muddy, 
and nervous derangement due to uremic poison, or to 
retention in the blood of uric acid and other salts that 
should be carried off by the urine. 



ACUTE BRIGHT'S DISEASE. 247 

Causes. — The disease is most common in young persons 
and is frequently caused by scarlet fever, diphtheria, and 
other diseases peculiar to childhood. It is also caused by 
the continued use of irritating drugs, especially turpentine. 

Symptoms. — Dropsical conditions coming on slowly, at- 
tended with general pallor, shortness of breath, and weak- 
ness, are the symptoms characterizing a mild case of this 
affection, but it generally commences more abruptly and of 
course with symptoms more severe, such as fever, sickness 
of the stomach and vomiting, and pain over the region of 
the kidneys. There is usually diarrhoea, and also an urging 
desire to urinate; pulse quick, strong, and full. Sooner or 
later dropsy develops, when all the features are swollen, 
the dropsical condition soon being apparent over the en- 
tire body. Blood poisoning frequently occurs from 'the 
suppression of the urine. 

Termination. — This is usually favorable, and under 
prompt and effective treatment recovery may be expected 
in from two to four weeks. A retention of the salts of 
the urine to the extent of producing that stupor or coma 
characteristic of blood poisoning from this cause, adds 
greatly to the gravity in all cases. 

Treatment. — The patient should be kept as quiet as 
possible ; everything calculated to irritate or disturb the 
nervous system should be avoided. As the affection is 
really an inflammatory one, the force and frequency of the 
heart's action should be modified by the use of a sedative 
as early in the disease as possible. The best is probably 
the tincture of veratrum veride, and may be given in two- 
drop doses to an adult, every hour for eight hours, unless 
it causes sickness and vomiting. In that case it must be 
stopped, and a little whiskey or brandy given to stop the 



248 THE URINE. 

sickness. Whether sickness occurs or not after eight 
doses are given, it is best to leave it off for a few hours 
and then give it in one-drop doses every hour. 

To avoid the irritating effects of the natural salts of the 
urine, these salts should be largely diluted with water so 
as to make the amount of water sufficient to take the irri- 
tating edge off of the salts and at the same time assist in 
washing them out of the body and preventing blood 
poison. If symptoms of such poison manifest themselves 
by the appearance of stupor, the remedies must be given 
at once to act on the kidneys, and the following is one of 
the best : — 

Sweet spirits of nitre, two ounces, 
Acetate of potash, a half an ounce, 
Water and simple syrup, of each an ounce. 
Mix, and give a teaspoonful every three hours. 
The bowels may be kept in an easy, open condition by 
giving the following : — 

Epsom salts, two ounces, 
Cream of tartar, two ounces. 
Mix thoroughly, and give a heaping teaspoonful at bed- 
time. 

The diet should be nutritious and unirritating, milk and 
animal broths being the best. Stimulants of every kind 
should be avoided, including tea and coffee. 

THE URINE. 

As the urine is always affected as regards color, quan- 
tity, and other properties by diseases of any kind that 
materially affect a person, the appearance of the urine as 
well as its weight and quantity often becomes an index, 



THE URINE. 249 

pointing to some well-known disease. Aware of the in- 
formation that the various changes of the urine afford re- 
garding diseases of the body, it becomes very important 
to know the characteristics of the urine in a state of per- 
fect health. The color of healthy urine is a light amber, 
or about the color of very weak tea. This color is due to 
the various salts that the urine holds in solution, most 
of them contributing, more or less, to deepen the color. 
Now if a tablespoonful of coffee is steeped in a gill of 
water the color will be nearly black and the coffee very 
strong. If the same amount be steeped in a quart of 
water the color will be very light and the coffee corre- 
spondingly weak. The same conditions regulate and gov- 
ern, in a great measure, the color and weight of the urine. 
For example : If the urine is scanty or small in quantity, 
it is practically sure to be high colored, as a certain 
amount of coloring matter must pass from the body every 
day. If the quantity of the urine is very large the color 
must be light and the weight but little above water. 
Therefore any disease that reduces the quantity of urine 
passed in a day will correspondingly increase the color. 
In all fevers the urine is scanty and of course high colored, 
and these two symptoms, " scanty and high colored," al- 
ways go together in giving the symptoms of fever, when 
as a matter of fact the quantity of urine passed almost 
always regulates the color. Of course there are certain 
drugs or certain articles of food that increase the color of 
the urine and impart to it an odor characteristic of the 
drug or food taken. 



250 EPILEPSY. 

EPILEPSY. 

This is a disease of a chronic, periodic character, at- 
tended with violent spasmodic contraction of the muscles 
and a sudden and total loss of consciousness. 

Causes. — The most frequent of all causes in epilepsy is 
heredity, as more than half the cases are traceable to 
hereditary influence. Excepting in those cases depending 
upon heredity, it is almost impossible to determine with any 
degree of accuracy the cause of epileptic convulsions. 

Symptoms. — In almost all cases of epilepsy the attack 
is preceded by warning or premonitory symptoms. These 
sometimes commence a day or so before the epileptic seiz- 
ure, and cousist mainly of melancholy or a distressed state 
of mind. In other cases the warning is very short, not 
being sufficiently long for the patient to find a place of 
safety. 

As the attack commences the patient falls, giving utter- 
ance to a scream that is characteristic of the affection. 
There is absolute loss of consciousness, the face is pale, and 
the muscles of the body intensely rigid. Soon this rigidity 
gives way to a convulsive action of the muscles that may 
last for five or ten minutes and sometimes longer. As the 
convulsion ceases a profound sleep sets in, which often lasts 
two or three hours. For some time after awaking, the 
patient is in a thoroughly bewildered state of mind. After 
the soreness caused by the violent action of the muscles 
subsides, and the nervous system drops into its normal 
channel, the patient is much more comfortable, is in a 
quieter and happier mood, and intellectually brighter than 
for some time before the attack. 

Treatment. — It is probable that the most important 



EPILEPSY. 251 

factor in the treatment of epilepsy is the selection and 
maintenance of a suitable diet. It is the opinion of the 
author — and his experience warrants the opinion — that 
meats of every kind should be abandoned, and the diet 
with the exception of milk and butter, should consist of 
fruits and vegetables. This theory has been extensively 
advocated, and patients have been told to use as little meats 
as possible. They usually interpret such advice to mean, 
that when they are real meat hungry they can have a good- 
sized piece of steak, chicken, or turkey, and with such 
interpretation they generally get about as much meat as 
other persons. If meat is allowed at all it is scarcely worth 
while to try to limit its use, and the only rational plan is to 
prohibit it absolutely. Extensive experience with vege- 
tarians who have lived for years and years without any 
animal food at all, enduring in the meanwhile the severest 
physical labor, has shown that a meat diet for the purpose 
of sustaining a strong and vigorous body is unnecessary, 
and that people are just as strong, physically and mentally, 
who live on fruits and vegetables as those who eat meats. 
For this reason there is nothing to be lost to the epileptic 
by forever giving up a meat diet, except the mere pleasure 
of eating animal food. 

Under a fruit and vegetable regime the blood-vessels of 
the body are not quite so full, the brain and nervous energy 
are less intense perhaps, and all the conditions favoring an 
outbreak of epilepsy are modified in their force. There is 
no doubt but such a dietetic course, if adopted sufficiently 
early in life, will cure a great many cases of epilepsy, but 
however efficient such a course may be, it should be con- 
joined with a proper drug treatment in order to break up 
the epileptic habit. 



252 EPILEPSY. 

A multiplicity of remedies have been suggested to 
either modify or postpone the attack, and bromide potas- 
sium has been given for years at a time for this purpose, 
the amount being from thirty to fifty grains per day for 
weeks. The drug simply acts as a check-rein to the ner- 
vous system and exercises no favorable influence upon the 
disease, except while it is being given, and yet when it is 
used in connection with a fruit and vegetable diet, it may 
exercise a curative effect by postponing the paroxysm suf- 
ficiently long to break up the epileptic habit. A far better 
remedy, however, and one that covers a wider range of 
cases, is valerianate of zinc. 

The best way to give it is in pill form commencing with 
one-grain doses. As to how often it should be given and 
when, much depends upon the violence and frequency of 
the attacks, and what time during the twenty-four hours 
they generally occur. If they are frequent and severe it 
should be given in grain doses three times per day, and in 
extreme cases the dose may be increased to a grain and a 
half. If the convulsions only occur about once per month 
a one-grain pill night and morning, conjoined with a fruit 
and vegetable diet, may postpone them for a long time, or 
entirely prevent their occurrence. 

In a great many cases the spasms come on in the night 
and never occur in the daytime. In dealing with this 
form of disease a one-grain pill given at bedtime some- 
times postpones an attack for a year or two, even though 
no attention is given to the patient's diet. 

Where the convulsions always occur at night, where the 
patient is under twenty years of age, and where the whole 
number of spasms do not exceed one or two hundred, the 
fruit and vegetable diet and valerianate of zinc at bedtime 



NEURALGIA. 253 

will often effect a cure. The highest authorities agree 
that where any patient has had five hundred spasms, the 
epileptic habit is so thoroughly fixed upon him as to render 
any treatment, so far as effecting a cure is concerned, 
hopeless. 

NEURALGIA. 

This is a disease affecting the nervous system and is 
attended with sharp, darting pains along the course of 
sensory nerves. 

Causes. — It may arise from heredity, malarial affections, 
exposures to wet and cold, from mental exertion, fright, 
intense anxiety, or from an injury to an important nerve. 
It is customary to name the disease according to the parts 
affected, as for example : When the neuralgic affection is 
confined to the face with sharp, darting pains either above 
or below the eyes, it is called tic-douloureux or facial 
neuralgia. 

When similar pains of a paroxysmal character affect the 
back of the head and extend down the neck, it is called 
cervico-occipital neuralgia, and signifies neuralgia affecting 
the back of the head and neck. 

Paroxysmal pains of a darting character, involving the 
neck, shoulder, arm, and hand, are called cervico-brachial 
neuralgia, which means neuralgia of the neck and arm. 

When similar pains of a paroxysmal type dart along the 
fifth and sixth ribs or the intervening spaces on one side, 
the disease is called dorso-intercostal neuralgia, or, more 
commonly, intercostal neuralgia, which simply means, 
neuralgia between the ribs. This form of neuralgia is 
nearly always attended with a bright red eruption of the 
skin known as " shingles," 



254 NEURALGIA. 

When neuralgic pains shoot along the course of the 
sciatic nerve, causing severe pain in the muscles of the hip, 
it is called sciatica. This form is generally associated with 
or depending upon an attack of lumbago, or muscular 
rheumatism of the back. 

The pain in sciatica is more intense and involves more 
important muscles than that of neuralgia of other parts 
of the body, and extends from the hip to the heel. The 
muscles of the hip, the inner part of the thigh, and ball of 
the leg are frequently all involved in a terrible paroxysm 
of pain at the same time. 

Termination. — Neuralgia, including all the different 
forms, should end in complete and perfect recovery if 
properly treated. 

Treatment. — Many years ago the author abandoned the 
plan of treatment given in the medical text-books which 
consisted, as it does now, of giving an opiate to relieve the 
violent pain of the paroxysm, and afterwards giving the 
necessary remedies to prevent recurrence of such par- 
oxysms. 

The best time to break up an attack of neuralgia, and 
to break it up so radically that it will never return, is dur- 
ing the paroxysm. 

Why this is so is not so easy to tell, but the fact is 
established by treating a large number of cases both ways, 
that is by giving remedies when patients are practically 
in a state of perfect health, and giving the same remedies 
during the attack, in both cases with a view of curing the 
disease. As long as the author followed the old plan of 
treating cases between the paroxysms, he failed to prevent 
their recurrence. Since substituting a curative treatment 
during the paroxysm for one of temporary relief, his 



NEURALGIA. 255 

efforts, with but few exceptions, have been crowned with 
perfect success. Instead of giving morphine or some form 
of opium to blunt the sensibility to pain, the proper thing 
is to give a remedy that increases the sensibility of the 
affected nerves and intensifies the pain for a limited time, 
knowing by experience that complete and permanent re- 
lief will follow. Such a remedy is the exact opposite of 
morphine in its action, and is strychnine, given in the con- 
venient form of ignatia pills. 

Before going into details regarding the treatment, it 
must be understood that all forms of neuralgia, excepting 
neuralgia of the heart, are treated the same way. As 
most people are familiar with sciatica and know something 
of the intense and prolonged suffering that it occasions, 
the treatment here given is for that disease. Suppose the 
pain is of the usual, sharp, lancinating kind, affecting the 
muscles of the hip and darting down the thigh and leg to 
the ankle, the pains being so great that the patient thinks 
only of something for immediate relief. In such a case, it 
seems cruel to give medicine to make him worse, and yet 
that is exactly the right thing to do. If he weighs 150 
pounds, or from that to 175, give him a three-quarter- 
grain pill of the solid extract of ignatia and in six hours 
repeat the dose, only giving three pills in twenty-four 
hours. This dose is calculated not only to increase the 
pain, but to cause cramps of the affected muscles. Should 
it fail to do so by the time the third pill is given, a one- 
grain pill of the same drug must be substituted for the 
three-quarter-grain pill, and one given before each meal. 
The contractions of the muscles of the hip, thigh, and leg, 
and also the attending pain, may be very severe. Should 
the pain be too great to bear, a half grain of morphine 



2^6 NEURALGIA. 

may be given at a single dose, as its effects will be neutral- 
ized to a great extent by the ignatia. After the spasm or 
cramp -of the muscles subsides, a sore feeling of the flesh 
for a few days is about all that is left, and the sciatica 
rarely returns. The success of the treatment depends 
mainly upon the extent to which the drug is carried in 
producing intense pain and muscular spasm. If only 
slight cramp with but little increase of pain is excited, the 
treatment will do but little if any good. There is no dan- 
ger whatever in the use of the drug as herein advised, and 
it is very probable that a three-quarter-grain pill will be 
sufficient, and that it will not be necessary to give more 
than three. 

If a one-grain pill is given, the second dose if not the 
first, will most likely bring on the desired cramp and inten- 
sified pain. 

The principle upon which the curative action of the 
remedy depends, can only be partially explained, and is 
probably as follows : During an attack the nerves con- 
cerned are congested or inflamed, and therefore intensely 
sensitive to the action of strychnine, which increases the 
congestion. 

A state of numbness or partial insensibility of the 
muscles follows, during which blood ceases to be at- 
tracted to diseased parts, and recovery commences. 

Why the attacks never return, it is hard to tell. 

It is thought best to report a few of the very many 
cases in which ignatia has been permanently curative in 
sciatica and other forms of neuralgia when given during 
the paroxysms. 

Case I. — Mr. Hersey, aged 60, had suffered for many 
years with violent attacks of sciatica, and in 1872, I was 



NEURALGIA. 257 

called and found him in great agony. It was found that 
the attacks came on a dozen times per year, and were 
always fearfully distressing. I decided then and there to 
break them up forever, if possible, and gave him a one- 
grain ignatia pill before breakfast, and another before the 
noon meal. At one 1 o'clock the violent contractions of the 
muscles began, the pain was terrible, and he was screaming 
as if he was being murdered. I gave him a half grain of 
morphine by the mouth, as I had no hypodermic with me. 
In a half hour the cramp in the muscles of the hip, thigh, 
and leg had almost ceased, and the pain was practically 
gone. Within two hours he was perfectly easy, and during 
the next twenty years of his life he never had another 
attack. 

Case II. — Mrs. G. W. Willis, of Mankato, Minn., ad- 
dressed a letter to me in Boston, in 1893, describing a 
neuralgic affection of the shoulder, arm, and hand, the 
form technically known as the cervico-brachial neuralgia. 
It had resisted all efforts to subdue it or even to favorably 
affect it, and had been torturing her for many weeks. 

The ignatia pills in three-quarter grain doses three times 
per day increased the pain considerably and caused mus- 
cular contractions in the arm, shoulder, and hand, and, as 
directed, she left off the remedy at once. Complete and 
permanent recovery followed. In this case, the cramp or 
spasm of the muscles was not very severe. She has 
never had an attack since. 

Case III. — William Whitehead, aged 35, had suffered 
with neuralgia of the back of the head and neck, the 
paroxysms occurring about twice per month and confining 
him to his room for a couple of days. He was put upon 
ignatia pills in doses of three-quarters of a grain before 



258 HYSTERIA. 

each meal, and the treatment was begun during the earli- 
est and severest part of the paroxysm. The first pill 
given caused some muscular spasm, and in an hour and a 
half after taking the second, violent cramps affecting the 
muscles of the back of the head and neck ensued, at- 
tended with terrible pain. The pain accompanying the 
cramps was finally so severe as to require a hypodermic 
injection of morphine, which gave complete relief within 
a half hour. In this case the paroxysmal attack which had 
usually lasted two days, was completely broken up in eight 
hours, and the habitual attacks that had been coming on 
every two weeks for years, never returned. 

Comment. — There was some very unpleasant experience 
in this case, owing to the terrific pain occasioned by the 
drug which was probably given in doses unnecessarily 
large. It may be that a half-grain pill instead of three- 
quarters would have answered, but there were no bad 
effects from the use of large doses except during a few 
hours, and the final result was so completely satisfactory 
that there was but little reason for complaint on account 
of severe treatment. 

HYSTERIA. 

Common name : hysterics. 

This is a functional derangement of the nervous system, 
characterized by more or less spasmodic action of the 
muscles, and seems to be associated with a morbid desire 
for sympathy, as the attacks almost always occur in the 
presence of other persons. 

Causes. — The affection is confined almost entirely to 
females, and is frequent among old maids, girls, and women 
without children. It is often associated with the monthly 



HYSTERIA. 259 

sickness, and also frequently occurs about the turn of life. 
It is probably always associated with functional derange- 
ment of the sexual organs, although those organs may 
seem to be in a state of health. It is doubtless aggravated 
by dyspepsia or anything calculated to disturb the nervous 
system. 

Symptoms. — The symptoms of hysteria are so numerous 
and varied that those of a typical case are exceedingly hard 
to catalogue. The fact that the paroxysms, attended with 
sighing, crying, or boisterous laughter, almost always occur 
in the presence of other persons and usually those of dear 
friends, relatives, or lovers, suggests the idea that the 
underlying cause of the seizure may be a morbid craving 
for sympathy ; and yet hysteria is truly a disease affecting 
the nervous system in such a way, that the absurd and 
meaningless demonstrations can neither be suppressed nor 
modified by the patient. There is laughter without mirth, 
moaning without distress, crying without grief, talking 
without saying anything, gestures that indicate nothing, 
threatened suffocation when there is no obstruction in the 
throat that is apparent. All these symptoms and some- 
times a great many others generally precede the hysteri- 
cal fit that is characterized by seeming unconsciousness, 
the patient usually being keenly aware of what is taking 
place. The paroxysm may be attended with violent strug- 
gles in which the patient has to be restrained to prevent 
injuring herself or others. There may be spasmodic con- 
traction of the muscles affecting the features and extremi- 
ties as if it were really an attack of epilepsy. 

Finally after the family and friends have been terribly 
frightened, fearing that death was imminent, the paroxysm 
may end abruptly in a sweet, placid, bewitching smile, the 



260 HYSTERIA. 

patient dropping into a quiet sleep. After all these violent 
symptoms have ended in quiet repose, a careful examination 
usually shows that the pulse and temperature are but little 
if any above natural. 

Termination. — As far as life is concerned, hysteria is 
always favorable. In regard to perfect recovery it is 
much less so, as persons who have had one attack are lia- 
ble to have others, regardless of treatment. 

Treatment. — In the great majority of cases it is impos- 
sible to tell the cause of hysteria, and for this reason the 
treatment is to a great extent experimental. A great 
many cases are undoubtedly due to the immoderate use of 
tea or coffee, by which the nervous system is unduly ex- 
cited, and sooner or later ends in a condition of partial ex- 
haustion, which favors an outbreak of hysteria. Nervous 
exhaustion also causes dyspepsia, to which many of the 
hysterical symptoms are often due. Therefore in all hys- 
terical cases attended with the excessive use of tea and 
coffee, these stimulants should be absolutely abandoned, 
as they are nerve exhausting, causing those who use them 
excessively to be intensely nervous. It is well to remem- 
ber that hysteria is simply an exaggerated or extreme con- 
dition of nervousness, and, aside from that, is no disease 
at all. And further, that any habits of eating and drink- 
ing or living that have a tendency to use up and exhaust 
nervous energy, have an equal tendency to carry every 
female patient in the direction of hysteria, as the nervous- 
ness from drinking strong tea and coffee is " hysterics " 
on a small scale. 

From the foregoing it is evident that the rational treat- 
ment of hysteria, with a view of preventing the paroxysms, 
is almost entirely hygienic, as there are no drugs that will 



SUNSTROKE. 26 1 

prevent hysterical paroxysms as long as their exciting 
causes exist. If the affection is associated with dyspepsia, 
that trouble must be met by giving a half-grain ignatia pill 
before each meal and continued for several months, but to 
permanently cure or greatly benefit any hysterical patient 
that persists in the immoderate use of tea, coffee, or other 
stimulants is a hopeless task. They should not use tea 
and coffee at all. 

One of the most efficient remedies in quieting the nerves 
and subduing an obstinate case of hysteria is the fol- 
lowing : — 

Fluid extract of valerian, a half ounce, 
Bromide potassium, a half ounce, 
Water, three ounces. 

Mix, shake, and give a teaspoonful, repeating the dose in 
six or eight hours if necessary. Patients usually drop into 
a quiet, restful sleep within an hour after taking the first 
dose. 

When hysteria depends upon disease of the womb, as it 
sometimes does, that organ must receive proper attention 
so as to remove the exciting cause of the disease. 

SUNSTROKE. 

Other names : thermic fever ; heat stroke ; coup de 
soleil ; heat exhaustion ; insolation. 

This is a condition in which the vital powers are over- 
whelmed with heat. It is not necessarily sunstroke, al- 
though this is the most common form of the affection, but 
may arise from heat of any kind. 

Causes. — The causes are exposure to the effects of high 
temperature, whether it be from the direct rays of the sun 



262 SUNSTROKE. 

or from artificial heat such as workmen encounter in roll- 
ing mills, furnaces, and foundries. 

Symptoms. — A heat stroke comes on rapidly with a 
feeling of great prostration, the face becomes pale, voice 
weak, pulse frequent and feeble, the patient sooner or later 
becoming unconscious. Occasionally the prostration is 
sudden, and without any warning symptoms the patient 
falls and is completely unconscious. In sunstroke the 
symptoms come on rapidly, sometimes preceded by a pro- 
drome and at other times without any warning symptoms 
whatever. The patient becomes irrational and may have 
a violent fit of delirium or convulsions, or instead of the 
latter, the exact opposite may occur — paralysis. . The 
surface is flushed with heat, the eyes are red, the breath- 
ing usually labored and puffing as in apoplexy. The pulse 
is quick and may be either full and strong or the opposite, 
small and weak. The fever often reaches the extreme 
limit. In such cases death usually occurs from suffocation 
or failure of the heart's action, or both. 

Termination. — Regarding the danger of this disease 
everything depends on the violence of the attack. In 
sunstroke most patients die within a few hours. 

Treatment. — In heat exhaustion it is best to put the 
patient in a horizontal position, and give good whiskey in 
half-tablespoonful doses in an equal amount of water 
every half hour. If unable to swallow, two or three times 
this amount may be thrown into the rectum, but in that 
case should be mixed with at least two parts of water. 

In sunstroke the fever is intense, often reaching the 
extreme limit, and the speedy reduction of the temperature 
is of the utmost importance. Cold water applied without 
limit to the surface of the body and especially the head is, 



NERVOUS EXHAUSTION. 263 

perhaps, the best means by which to get rid of the bodily 
heat. The face should be inclined a little downwards so 
the water will not enter the nostrils nor the mouth, and a 
constant stream of water flowing all over the head and 
neck should be poured from a pitcher. Meanwhile the 
body should be thoroughly wet with a spray or shower 
bath, and evaporation favored by the use of fans or having 
the patient in a draught of air. Everything depends on 
getting rid of the heat as soon as possible. 

NERVOUS EXHAUSTION. 

Other names : nervous prostration ; spinal irritation ; 
neurasthenia. 

This is an enfeebled state of the nervous system that 
reduces the physical and mental energy of an individual, 
rendering him less capable of dealing successfully with 
the affairs of life. 

Causes. — The principal causes are excessive mental 
labor, financial embarrassments, extreme and long-con- 
tinued anxiety from any cause, disappointments in love, 
excessive sexual indulgence, and the use of alcoholic stim- 
ulants and tea and coffee. 

Symptoms. — When nervous prostration affects every 
organ of the body, it is properly termed general nervous 
debility. When it affects but one organ it is local or par- 
tial nervous debility. This is the case in dyspepsia, when 
the nerves presiding over the functions of digestion are 
exhausted by excessive eating or the use of improper food. 

In nervous exhaustion there is an irritability of temper, 
the memory is more or less defective, the patient is unable 
to keep his mind fixed upon his occupation, forgets or 



264 NERVOUS EXHAUSTION. 

neglects business engagements, is a chronic "day- 
dreamer," and usually afflicted with insomnia at night. In 
females, nervous prostration is generally attended with 
functional derangement of the sexual organs. 

Termination. — This is usually favorable under proper 
management. 

Treatment. — In dealing with nervous exhaustion, hy- 
gienic measures are of the utmost importance. To free 
the mind from the annoying cares of life and make the 
individual as cheerful and happy as possible, transcends 
any and all efforts that can be made with a drug treat- 
ment. In almost all cases of nervous debility, disorders of 
digestion seriously complicate the situation. The nervous 
exhaustion causes the dyspepsia, and the latter constantly 
tends to increase the nervous exhaustion. For this reason 
an effort must be made at once to improve the digestion, 
fill the veins and arteries with healthy blood, properly 
nourish, tone up, and stimulate the nerves, and in that way 
maintain a healthy and vigorous nutrition. The best rem- 
edy in such cases is the solid extract of ignatia in pill form, 
the dose ranging from a half to a full grain according to 
the size of the patient. Persons weighing from one hun- 
dred to one hundred and seventy-five pounds, should take 
a half-grain pill before each meal. Those weighing from 
one hundred and seventy-five to two hundred will need 
three-quarters of a grain, while all persons weighing over 
two hundred must take a full grain. In all cases one pill 
is taken before each meal, and never more than one. 
They do not act as a physic, but spend their entire force 
upon the nervous system. They should be continued as 
a general thing for several months. After the dyspepsia 
is overcome and a healthy color has returned to the cheeks, 



ST. VITUS'S DANCE. 265 

the blood will properly stimulate the brain and nervous 
system, the latter will excite the organs of digestion to the 
proper performance of their functions, and further use of 
the ignatia will be unnecessary. 

ST. VITUS'S DANCE. 

Other names : chorea ; insanity of the muscles. 

This is a derangement of the nervous system, attended 
with irregular, jerking movements of the muscles. 

Causes. — It is a disease of childhood and youth, and 
may be due to heredity, masturbation, or fright. 

Symptoms. — The disease is gradual in its commence- 
ment, the muscles of the face and hands commencing to 
twitch about the same time. These symptoms may occur 
more or less every day, and then cease for a day or two, 
but finally becoming more pronounced so as to involve 
the muscles of the eyelids, the eyes, and those of the upper 
extremities. Last of all, the muscles of the lower 
extremities are affected. 

Termination. — In most cases this is favorable. 

Treatment. — As the disease is attended with a weakened 
condition of the nervous system, and consequent disorders 
of digestion, and an impoverished state of the blood, a 
general nervous tonic is called for with a view of giving 
general tone to nerve tissue, improving the powers of 
digestion, and filling the veins and arteries with healthy 
blood. Therefore, in children from two to eight years 
old, the eighth of a grain of the solid extract of ignatia 
should be given in pill form three times per day before 
the meals. At the same time the following may be given 
three times per day after meals : — 



266 SHINGLES. 

Fowler's solution, one drachm, 
Water, four ounces. 

Mix, and give a teaspoonful after each meal. 

In children under two years, this remedy may cause 
swelling or puffing of the eyelids within six or eight 
weeks, or sooner. When this condition is observed, the 
drug should be discontinued for two weeks and then 
given as before. If the child is from eight to fifteen years 
old, it should have a quarter of a grain pill of the solid 
extract of ignatia before each meal, and three or four 
drops of Fowler's solution after each meal. Meanwhile, 
the diet should be nutritious and the child should be kept 
quiet. 

SHINGLES. 

Other names: intercostal neuralgia; herpes zoster; 
a girdle ; zono. 

This is an acute inflammation of the skin, upon which 
there is a cluster of pimples or vesicles, and is attended 
with severe neuralgic pains. 

Causes. — The neuralgia and eruption are caused by 
inflammation of a nerve or nerves. 

Symptoms. — It begins with neuralgia, the pains being 
sharp and darting, characteristic of that disease, and 
usually situated on one side of the chest. Soon after the 
neuralgic seizure, the eruption, which is of a bright red 
color, commences. 

Termination. — In almost every part of the civilized 
world, the idea prevails that shingles, should the infection 
ever encircle the entire body, would prove fatal. There is 
nothing more foolish and groundless than this notion, as 
the termination is always favorable. 



MENSTRUATION. 267 

Treatment. — It is a self-limited disease, running its 
course in about two weeks, but is often attended with 
distressing pain, and should be broken up as soon as 
possible. For this purpose there is no better remedy 
than the following : Extract of ignatia in pill form, given 
three times a day, the dose ranging from one-half to a 
full grain. The pills should be sufficiently large to 
intensify the neuralgic pains, and should it also cause 
twitching of the muscles without severe cramp or mus- 
cular spasm, it is all the better. After the characteristic 
effects of the drug are obtained in this way, it is unneces- 
sary to give it any longer, as the neuralgia almost always 
subsides as soon as the drug symptoms die out. In such 
cases the shingles dry up, and the patient is practically 
well in forty-eight hours. Give a three-quarter-grain pill to 
adults. 

FEMALE DISEASES. 

Menstruation. 

Menstruation consists of a discharge of blood, once per 
month, from the sexual organs of the human female, dur- 
ing that period of her life in which she is capable of bear- 
ing children. 

The discharge is commonly called the menses because it 
occurs once per month, as the word " mensis " means a 
month, and when a girl has her first menstrual sickness, 
it is hailed as an unmistakable sign that she has arrived at 
the period of life called puberty, or, in other words, woman- 
hood. About this time her mammary glands, commonly 
called her breasts, show increased growth, she is widened 
and enlarged in the development of her hips, is somewhat 
more womanly in her manners, being unusually dignified 



268 FEMALE DISEASES. 

and reserved in the presence of boys. In this country, 
menstruation usually commences between the fourteenth 
and sixteenth years, and terminates between the forty- 
eighth and fifty-second years. 

The time which most commonly elapses between the 
successive appearances of the so-called monthly discharge 
is about four weeks, although it is frequently shorter ; and 
the duration of the flow is usually three or four days, but 
is liable to greater variations. The first appearance of the 
discharge, as a general thing, is preceded and accompanied 
by pain in the loins and general disturbance of the system, 
and in many women these symptoms invariably accompany 
the discharge. 

As menstruation rarely occurs during pregnancy and 
lactation, the cessation of the menses is hailed as the first 
symptom that conception has taken place. 

In the natural or primitive condition of the human race 
preceding the dawn of civilization, it is supposed that the 
menstrual function was unattended by pain. In that period 
of human development, there was much less difference 
between the size and physical strength of the male and 
female than at present ; her limbs were untrammelled by 
skirts, her body was not dwarfed nor distorted by tight 
garments, her muscular system was strong and vigorous in 
development, the cavities of her body containing the vari- 
ous organs were not diminished in size, and she was a 
natural, and not an artificial, woman. Being entirely unre- 
strained by garments, she had the same opportunities for 
exercise and physical growth that the male enjoyed. She 
was much larger in her waist, her hips and pelvis were 
larger, affording greater room for the internal sexual 
organs, and these were correspondingly strong and large. 



MENSTRUATION. 269 

The general trend of civilization has been to a higher intel- 
lectual development, to the neglect of her physical growth 
and strength, and conjoined with this, there has existed for 
centuries a morbid and gradually increasing desire to beau- 
tify her person by deforming it. School-girls are hampered 
by clothing, cannot play at games requiring the free and 
perfect use of all their limbs and muscles, and in this way 
the mothers of our race are restrained and enfeebled, physi- 
cally, so that the various functions of womanhood and 
motherhood are attended with more or less pain and incon- 
venience. Therefore menstruation, which is a natural 
physiological function and should be free from pain, is 
usually attended with suffering. That the restraining effect 
of modern styles in dress and their constant encroachments 
upon female anatomy, change the form from the natural 
to the unnatural, and are a continued menace to the 
happiness, comfort, and usefulness of woman, there can be 
no doubt. This question has been under discussion for 
many, many decades, and yet the evil continues. Reforms 
in dress are a thousand times more important to the women 
of this age and through them to humanity, generally, than 
the ballot, and yet they are justly entitled to the latter. 

But the general condition of humanity is improving ; the 
world is better this year than it was last ; the relics of bar- 
barism are becoming less conspicuous ; superstition is dying 
out ; women can speak in meeting with their heads uncov- 
ered ; the once enthroned monster of the skies is becoming 
an indulgent and loving father ; the superstition regarding 
the sacred form of females has disappeared; women have 
ceased to be the property of men ; are no longer the 
cherished tools of kings and monarchs, with their faces 
veiled from the eyes of other men ; are now, more than 



270 FEMALE DISEASES. 

formerly, the guardians of their own persons ; have unlim- 
ited sway in establishing and maintaining the various styles 
with reference to dress, and if they do not cast off that pet 
garment of ancient and jealous kings, that leg-hampering, 
speed-preventing, wage-reducing, exercise-restraining thing, 
— the skirt, — and don, instead, the bifurcated garment, it is 
their own fault. The idea of women adopting a male 
costume to the extent of getting rid of skirts, even though 
it gives them all the freedom of muscles and limbs that 
men enjoy, is at first horrible to think of, as we cannot 
endure the idea of seeing our wives or sweethearts thus 
clad. We have learned to love and admire women and 
girls in skirt garments, and for this reason it does not seem 
they can ever look so pretty in anything else ; but all 
prejudice, dislike, and opposition to male attire for the 
lower extremities of women would disappear in a year ; 
they would enjoy the same admiration of men that they do 
at present ; they could perform all the duties of life with 
much less inconvenience, could earn more money with less 
work, enjoy better health, gradually become stronger; 
girls could romp, run, jump, and play without restraint ; 
physical growth would be favored instead of retarded ; we 
would have larger, stronger, and more perfectly developed 
women ; the pains and frailties of womanhood and maternity 
would be greatly diminished, and in a few generations the 
mothers would enjoy the strength and immunity from suf- 
fering that those of the savage races now enjoy, while their 
capacity for intellectual development would be commen- 
surate with their increased physical strength. The multi- 
plicity of skirts that are belted around the waists of women 
and girls, that impinge uncomfortably upon the abdominal 
organs, forcing them downward upon those of the pelvis, 



MENORRHAGIA. 27 1 

that hamper the limbs, limit physical exercise, cause dis- 
orders of digestion and permanent derangement of the 
sexual organs, must sooner or later give place to sensible 
garments suspended from the shoulders, similar to those 
worn by the male sex. 

Menorrhagia. 

excessive menstruation. 

This is an affection in which the menstrual flow is 
changed into an absolute hemorrhage from the womb, 
and yet in some women it occurs as regularly as the 
monthly periods themselves, is attended with a discharge 
of large clots of blood, the expulsion of which requires 
bearing down efforts and pains similar to a miscarriage. 

The hemorrhage in such cases may be due to many dif- 
ferent causes, such as polypus of the womb, cancer, or 
malignant growth of some kind, but in the great majority 
of cases it is due to an idiosyncrasy, or personal peculi- 
arity of the patient and is, in itself, unattended with dan- 
ger. It is, however, to be greatly deplored for two reasons, 
namely : It is distressingly painful and annoying while it 
lasts. In the second place it drains the patient of so much 
blood that she is left in a weakened condition, her face 
being characterized by the pallor of childbirth. 

Treatment. — If the patient is of a florid complexion, 
the veins and arteries seemingly full of healthy blood, 
and there is for this reason a natural tendency to hemor- 
rhage, a meat diet should be almost abandoned for one of 
fruits and vegetables. This is especially necessary if 
she is habitually constipated. Whatever derangement of 
digestion and other functions of the body exist, should be 



272 FEMALE DISEASES. 

corrected by the proper treatment. If she is a subject of 
dyspepsia she should adopt the treatment advised in the 
chapter on atonic dyspepsia. If habitually constipated 
let her follow, in a thorough and radical manner, the 
treatment advised in the chapter on constipation. In 
order to arrest the hemorrhage when it occurs, and, there- 
fore, prevent the formation of blood clots and the accom- 
panying pains of such profuse menstruation, the following 
should be given as soon as the hemorrhage sets in : — 
Fluid extract of black haw, one ounce, 
Port wine, a half pint. 

Mix, and give a tablespoonful every hour until the hemor- 
rhage is arrested, then give the same dose every three or 
four hours until the time for the excessive flow has past. 

This remedy is one of the very best in such cases and 
affords the most prompt and satisfactory relief without 
leaving an unfavorable drug effect upon the patient, and 
yet it is not always easy to tell the proper dose for any 
particular case nor how often it may be necessary to repeat 
such doses. This information must be gained by experi- 
ence, as one lady may require much larger doses than 
another. As a general thing, however, if given as ad- 
vised, every hour, two or three doses will arrest the hemor- 
rhage. Every lady who is subject to profuse menstruation, 
characterized by great pain and the discharge of blood 
clots, should keep a bottle of this mixture in the house and 
commence taking it as soon as the hemorrhage begins. 

In more desperate cases, where the hemorrhage is so 
great as to give but little time for the action of medicine, 
a full teaspoonful of the fluid extract of ergot may be 
given every fifteen or twenty minutes, until the hemorrhage 
ceases, or until three doses are given. In most cases, 



AMENORRHEA. 273 

however, the fluid extract of black haw is much to be pre- 
ferred, as the use of ergot every month is liable to cause 
permanent injury to the blood-vessels. 

Amenorrhcea. 
suppression of the menses. 

This is a condition due to one of many causes, or several 
combined, in which the regular monthly sickness fails to 
occur, or which, having commenced, is suddenly suppressed. 
It is frequently caused by a severe cold, or being caught 
in a rain-storm about the time the flow should commence 
or soon afterwards. In such cases great pain in the pel- 
vic region, headache, thirst, fever, a full and rapid pulse 
may follow. 

Treatment. — To treat amenorrhcea rationally with the 
hope of obtaining favorable and permanent results, every- 
thing depends upon the cause producing it and the way in 
which it affects the individual. If the menses are sup- 
pressed by cold or by getting wet, the prompt and thorough 
application of heat will afford the surest and quickest 
relief, and for this purpose there is nothing better than 
hot water as advised in the treatment of dysmenorrhea. 
This should be followed up for several hours, keeping 
patient, meanwhile, somewhat uncomfortably warm in bed. 
If there is much fever, the following should be given as 
directed : — 

Tincture of aconite root, one drachm, 
Water, four ounces. 

Mix, and give a teaspoonful every hour for four hours, 
after which give a dose every two hours. The menses are 
frequently suppressed or delayed by grief, fright, or undue 



274 FEMALE DISEASES. 

mental excitement. In such cases the trouble is tempo- 
rary so far as the menses are concerned, and will disappear 
as soon as the equilibrium of the nervous system is re- 
stored. The treatment, if any, consists in quieting the 
mind. The failure of the menses to occur on time affords 
no occasion for alarm unless the health of the individual is 
unfavorably affected. One of the greatest misconceptions 
of parents and frequently of doctors also, is that physical 
derangements of young ladies are solely due to the sup- 
pression of menses, when actually the suppression in most 
cases is caused by the physical infirmities. There are 
certain diseases in which the menses are almost always 
suppressed, and one of the most serious and important of 
these is consumption. This is usually slow and insidious 
in its development, and attracts but little attention until it 
is discovered that the color has faded from the cheeks and 
the menses have failed to appear. The misguided doctor 
or parent is led to think the trouble is all in the sexual 
organs, and gives remedies to restore the menses. These 
are wasted efforts, as it is just as natural for the menses to 
be suppressed with consumption as it is for them to occur 
on time in health. Other debilitating diseases affect 
females in the same way, and the treatment should be 
directed to such diseases instead of the sexual organs. 
Suppression of the menses by disappointments in love is 
very serious, as in many cases it is the beginning of a 
fatal decline, but the trouble is in no way connected with 
the sexual organs, as it is wholly a mental condition. The 
derangement is primarily emotional and mental, leading to 
derangements of nutrition, vital depression, and consump- 
tion. The morbid condition of the mind must be over- 
come before the menses can be restored. 



DYSMENORRHCEA. 275 

Dysmenorrhea. 

painful .menstruation. 

Dysmenorrhcea is the technical term applied to the pain 
that precedes or accompanies the menstrual discharge. 
Most women are more or less uncomfortable during the 
first day of their monthly sickness, the pain frequently 
preceding the flow. Where this discomfort is moderate 
it is not called dysmenorrhcea, or painful menstruation, 
but is considered natural. But in many cases the pain is 
severe, covering a period of two or three days, and confin- 
ing the patient to her bed. 

The causes of painful menstruation are numerous, the 
remote causes being almost wholly errors in dress, produ- 
cing more or less physical deformity, including a meagre 
development of the sexual organs. It is obvious from the 
foregoing that the remote causes are, to some extent, hered- 
itary, that mothers for many generations have suffered 
from the same kind of mistakes in dress that are diminish- 
ing the comfort and happiness of the present generation 
of women. When an anxious father wrote to Horace 
Greeley asking him the best time at which to commence the 
education of his boy, the old philosopher answered : 
"About one hundred years before he is born." The same 
kind of advice applies to dysmenorrhcea, and the treat- 
ment should be commenced several generations before the 
birth of the patient. 

The exciting causes of painful menstruation are many, 
among which may be included inflammation of the ovaries, 
or the membranous lining of the womb, or mechanical 
obstruction preventing or retarding the flow of the men- 
strual fluid from the womb. 



276 FEMALE DISEASES. 

Symptoms. — Where inflammation of the ovaries exists 
there is a heavy, aching pain in the pelvis before and 
during the menstrual discharge, with soreness of the 
breasts and sometimes swelling also. The time at which 
the pain sets in, with reference to the commencement of 
the discharge, affords information that is somewhat reliable 
regarding the cause. For example : where there is inflam- 
mation of the ovaries, the pain precedes the flow and is 
not relieved when the latter is established. 

When the suffering is due to an obstruction in the 
mouth of the womb, the pain precedes the flow and is 
greatly if not wholly relieved by it. Where inflammation 
of the mucous lining of the womb causes the suffering, 
the pain commences with the flow and is gradually in- 
creased as the accumulated fluid with more or less clots 
impinges upon the inflamed membrane. In such cases, 
however, the freer the discharge the less will be the suffer- 
ing from pressure upon the inflamed surfaces. This form 
is sometimes called membranous dysmenorrhcea, as the 
discharge is frequently accompanied with the passage of 
detached fragments of membrane. 

Treatment. — Where there is heavy, aching pain in the 
pelvis before and during the discharge, and attended with 
soreness of the breasts, it indicates an inflammatory con- 
dition of the ovaries, and the application of heat in the 
form of a rubber bag filled with hot water and placed over 
the lower part of the abdomen, keeping a thick, dry towel 
between the bag and the skin to prevent burning the 
patient, will usually afford great relief. The heat thus 
applied is valuable in relieving the inflammation of the 
ovaries and effecting a relaxed condition of the mouth of 
the womb to facilitate the flow. If, however, a case of 



DYSMENORRHEA. 277 

this kind is so severe that this treatment does not afford 
the desired relief, from twelve to fifteen grains of anti- 
pyrine may be given, and the dose repeated in two hours 
if necessary. Alcoholic stimulants of all kinds should be 
avoided in dysmenorrhoea, and especially so in the ovarian 
form. The treatment of the patient between the men- 
strual periods is of great importance when the painful 
menstruation depends upon an inflammatory condition of 
the ovaries. The use of hot water as a vaginal douche 
three or four times per week, if properly managed, ought 
to accomplish a great deal in unloading the engorged ves- 
sels of the ovaries and rendering the succeeding monthly 
flow much less painful. 

The best way to administer the treatment is by means 
of a fountain syringe. It is best for the patient to be in a 
bath-tub with her hips resting upon some soft cushion 
several inches high. The water should be as hot as it 
can be borne without pain, and the flow continued for ten 
minutes, the waste water being allowed to escape from 
the bottom of the tub. 

When the pain precedes the flow and is always relieved 
by it, it is evident that the suffering is caused by a rigid 
condition of the mouth of the womb that prevents or 
retards the flow. Heat in some form is the best means to 
secure a prompt relaxation of the womb, and get rid of the 
accumulated fluid and the pains also by a free discharge. 
The application of hot water by the rubber bag, as men- 
tioned above, will afford prompt relief. 

When pain commences with the flow and gradually 
increases, it indicates inflammation of the mucous lining 
of the womb, and every effort should be made to facilitate 
the flow and prevent undue pressure upon the inflamed 



278 FEMALE DISEASES. 

surfaces. Heat is usually the best means to secure this 
end also, and the rubber bag filled with hot water can be 
used to advantage. Bags of hot salt, or a jug filled with 
hot water and securely corked, will afford convenient 
means of supplying the heat. This form also may be 
greatly relieved by irrigating the vagina with hot water 
three or four times per week between the monthly periods. 

In dysmenorrhea, of whatever form, disorders of diges- 
tion should be corrected as soon as possible, and where 
constipation exists, a meat and mixed diet should be aban- 
doned for one of fruits and vegetables. An abundance of 
fruits, of which apples, oranges, lemons, and peaches are 
the best, should be eaten every day until the bowels move 
about once per day. The stools should be soft and easy 
so as to avoid the necessity of straining, as such efforts 
do great harm by causing congestion of the internal sexual 
organs and causing or increasing painful menstruation. 
Where the affection is due to constipation, and it very 
often is, the fruit diet, followed for all it is worth, will 
effect a cure. 

In such cases everything depends on the amount of 
fruit eaten, and the regularity with which the fruit-diet 
treatment is followed up. Some patients will eat an apple 
once or twice per day, or an orange at bedtime, and if 
their constipation is not promptly relieved will become 
discouraged and give up the use of fruit. Eating fruit in 
such limited quantities will do no good, but if four or five 
raw apples are eaten in twenty-four hours, and fried or 
stewed apples are eaten at one or two meals per day, or, 
in place of apples any other fruits that may be desired, 
excepting raspberries and blackberries, the fruit acid will 
soon have a favorable effect upon the bowels, and a free and 



LEUCORRHCEA. 279 

easy movement once per day may be hoped for. Fruits 
do not act upon the bowels as a physic, and therefore it 
does not become necessary to increase the amount. There 
is one matter of caution regarding the treatment of dys- 
menorrhcea, that is of the utmost importance. It is this : 
Never take a physic of any kind, as physicking in any 
way has an absolute tendency to cause congestion of the 
pelvic organs. Wherever patients have dyspepsia, they 
should carefully follow the treatment given in the chapter 
of this book devoted to atonic dyspepsia. 

Leucorrhcea. 
"the whites." 

This is a disease attended with more or less profuse dis- 
charge of white, yellowish, or greenish mucus from the 
vagina, resulting from acute or chronic inflammation of 
the vaginal mucous membrane. 

As inflammation or irritation of the mucous lining of the 
vagina is the cause of leucorrhcea, it is very evident that 
the exciting causes of the disease consist of any influence, 
mechanical, sexual, or otherwise, that is calculated to excite, 
irritate or inflame the vaginal wall. Therefore, leucorrhcea 
is caused by displacement of the womb downwards, in 
which the tendency is to turn the vagina wrong side out 
and chafe and irritate the two opposing surfaces. As all 
mucous membranes when irritated, secrete mucus, a flow 
of watery mucus necessarily follows such displacements 
of the womb. Then again, if the womb is tipped back 
against the rectum, called retroversion, the mouth of the 
organ is directed toward the bladder, and impinges uncom- 
fortably upon the front wall of the vagina, producing irri- 



280 FEMALE DISEASES. 

tation and consequently leucorrhcea. When the womb is 
tipped forward, the mouth is directed backward toward the 
rectum and irritates the back part of the vagina, causing a 
flow of watery mucus. The most frequent and serious of 
all the causes of leucorrhcea are probably those of womb 
displacement, and any attempt to cure the affection until 
these mal positions are corrected, can do but little, if any, 
good. 

One of the most frequent and provoking causes of leu- 
corrhoea, is excessive sexual indulgence. The excitement 
of sexual intercourse necessarily, naturally, and properly 
causes temporary congestion of the internal sexual organs, 
including the mucous membrane of the vagina. This is a 
physiological action and harmless if not carried to excess, 
but too frequent sexual indulgence gradually produces a 
chronic inflammatory condition called vaginitis, in which 
every part of the inflamed mucous membrane becomes 
active in the secretion of a watery mucus and sometimes 
of pus also. Another cause of leucorrhoea is the retention 
within the vaginal cavity of blood clots after profuse men- 
struation. 

Treatment — As the form of womb displacement most 
conducive to leucorrhcea is downward, the remedy is easy 
and simple if commenced in time, and consists in the in- 
sertion of a soft rubber ring, the opening in the centre 
being large enough for the mouth of the womb. This ring 
is hollow, and integral with it is attached a rubber tube 
about eighteen inches long, for inflating the ring when it 
is properly introduced. To place it in the vagina in the 
correct position, it is covered with vaseline and pushed 
as far as possible with the index finger. Then the small 
point of a common bulb syringe is forced into the end of 



LEUCORRHCEA. 28 1 

the rubber tube. When the bulb is thoroughly compressed 
twice, the ring will be considerably inflated. The index 
finger, properly oiled, may now be used to further adjust 
the ring so that the mouth of the womb strikes* the open 
centre. By compressing the bulb once more the ring is 
fully inflated, extending itself in every direction and for- 
cing the womb upwards. Sometimes it is not necessary, 
and this is especially true in women who have not borne 
children, to compress the bulb more than twice, as that 
amount of inflation is often sufficient to correct the dis- 
placement. If when the patient gets up and commences 
to walk round, the distended ring causes pain, it is an evi- 
dence that the inflation is too great. If, on the other hand, 
there is no pain at all, and a constant tendency of the ring 
to be discharged from the vagina, the inflation is not suffi- 
cient, and the bulb should be compressed three times 
instead of twice. After the ring is properly blown up, 
the rubber tube is to be firmly tied with a piece of cotton 
twine of considerable size. It should be tied in three 
knots. When necessary to remove the ring, the knots 
may be untied, or the tube clipped with scissors just above 
the cord. This form of uterine support is almost wholly 
free from irritation, and almost any woman can properly 
introduce it. 

In leucorrhoea depending upon excessive sexual indul- 
gence, intercourse should be wholly abandoned until the 
vaginal canal recovers from the irritable or inflamed con- 
dition causing the discharge. Meanwhile, irrigating the 
vagina two or three times per day with warm water and 
using an injection of sulphate of zinc after each cleansing, 
will hasten recovery. A teaspoonful of the zinc will be 
enough for a quart of water. It should be injected with a 



282 FEMALE DISEASES. 

hard rubber female syringe holding about one ounce. An- 
other very valuable remedy, and in many cases much 
better than the zinc, is the non alcoholic extract of hy- 
drastis canadensis mixed with ten parts of water. This 
should be injected night and morning. Any preparation 
injected for the cure of leucorrhcea should not be suffi- 
ciently strong to cause much if any pain, and when sul- 
phate of zinc is used, if it causes much smarting, more 
water must be added to the solution. 



Displacements of the Womb. 

There are five displacements of the womb. First, ante- 
version, in which the fundus or top of the womb is thrown 
forward against the bladder, greatly diminishing its capac- 
ity to hold urine, in consequence of which the patient has to 
pass her water much oftener than usual, and in bad cases 
every fifteen or twenty minutes. At the same time the 
mouth of the womb presses against the rectum, often caus- 
ing constipation. Second, retroversion, in which the fundus 
or top of the womb is thrown backwards against the rec- 
tum, causing, if during pregnancy, terrible obstruction of 
the bowels. Meanwhile the mouth of the womb is pointed 
towards the front of the pelvis, impinging so firmly upon 
the neck of the bladder that the patient is frequently un- 
able to pass her water. In such cases the direction of the 
urethra is very much changed, and a catheter that is con- 
siderably curved must be substituted for the one commonly 
used. Third, anteflexion, in which the womb is bent for- 
ward so the fundus or top presses upon the bladder, while 
the mouth is in its normal position or nearly so. The 
symptoms of this form of displacement are much the same 



DISPLACEMENTS OF THE WOMB. 283 

as those of anteversion, so far as the effect upon the blad- 
der is concerned, as it is compressed and diminished in its 
capacity to hold water, frequent urination being necessary. 
It does not, however, obstruct the bowels. Fourth, retro- 
flexion, in which the fundus or top of the womb is bent 
backward against the rectum, frequently causing obstruc- 
tion of the bowels, while the mouth of the organ remains 
in its natural position or practically so. Fifth, falling 
of the womb, in which the organ is forced downward in 
the pelvis. This may be slight, causing but little incon- 
venience, or it may be great, in which there is almost com- 
plete prolapse or protuding of the womb. The symptoms 
of this form of displacement are backache, pains in the 
lower part of the abdomen, frequently extending down the 
thighs, a sense of heaviness or bearing down in the pelvis, 
and usually a frequent desire to pass water. 

Treatment. — In all these displacements it is much better, 
if possible, for the patient to lie in bed until the womb is 
returned to its natural position. In retroversion that oc- 
curs mostly during pregnancy, obstructing the bowels and 
also frequently causing abortion, a good physician should 
be called at once to correct the position of the womb by 
putting patient on her knees and breast, and inserting one 
or two well oiled fingers in the rectum and pushing firmly 
against the womb. The other mal positions of the womb 
will generally correct themselves by the patient lying in 
bed a couple of weeks, but in case of prolapse, where the 
displacement is altogether downward, the soft rubber ring, 
as advised for such displacements in the treatment of 
leucorrhcea, may be used, in which case it is usually un- 
necessary for the patient to lie in bed. The reader is re- 
quested to turn to the chapter on leucorrhcea, and carefully 



284 FEMALE DISEASES. 

study the soft rubber ring and the manner of introducing 
and inflating it. 

Whenever a woman is seized with a very frequent de- 
sire to pass her water, and this condition continues for any 
length of time, it is very safe for her to conclude that she 
has womb displacement of some kind. In the large ma- 
jority of cases the position of the womb can be corrected 
by the patient taking to her bed for a few days, pro- 
vided she does so as soon as the troublesome symptoms 
make their appearance. If this is not convenient the soft 
rubber ring or pessary, if properly inserted and sufficiently 
inflated, will raise the womb off of the bladder so as to cause, 
in most cases, immediate relief. In cases of anteflexion, 
where the top of the womb is bent forward against the 
bladder, there is frequently more or less displacement 
downward, and the use of the soft rubber ring will correct 
the trouble. It is well to remember that all these displace- 
ments have a natural tendency to irritate the vaginal canal 
and cause leucorrhoea, and whenever this flow commences, 
whether associated with bladder troubles or not, displace- 
ment of the womb should be suspected. 

PREGNANCY. 

Pregnancy in the human family, when of the normal or 
natural character, signifies a state of the female in whose 
womb there is a germ, or egg that has been fertilized by 
the male germ, and which gradually becomes developed 
within the cavity of the womb. When the ovum is im- 
pregnated or fertilized by the male semen in the uterus, a 
local, vital action is set up by which it attaches itself to 
the surface of the mucous membrane lining the womb, and 



PREGNANCY. 28$ 

obtains from it indirectly the nourishment necessary for its 
gradual growth during the ordinary term of pregnancy. 
The duration of pregnancy, however, may be protracted to 
three hundred days or upwards, and ends with the birth 
of one or more children. Pregnancy is commonly limited 
to one child, but sometimes there are two or three, and in 
rare instances four or five. 

Signs of Pregnancy. 

The first symptom of pregnancy, and the one hailed by 
almost all married women as the most important, is sup- 
pression of the menses. The function of menstruation 
rarely exists during the period of pregnancy. Sometimes, 
however, the menstrual flow occurs once after conception 
takes place, but in such cases it is generally slight and 
limited in duration. When it thus occurs it is only a short 
time after conception has taken place. The suppression 
of the menses, however, as a sign of pregnancy, is so 
reliable that the date fixed for the probable birth of the 
child is two hundred and seventy-five days after the last 
day of the last menstruation. When a menstruation in a 
married woman is limited both in quantity and duration, 
and this too in one who has always been regular as to time, 
amount, and duration of the flow, it is a very strong evi- 
dence that conception has taken place. As it may have 
occurred several days previous to the flow, the duration of 
pregnancy when reckoned from the last menstrual flow, 
must necessarily be shortened. 

The menses are not always suppressed during preg- 
nancy, but the cases in which they are not, are exceedingly 
rare. 

The value of menstrual suppression as a sign of preg- 



286 FEMALE DISEASES. 

nancy is modified by many conditions. If the individual is 
very irregular in this respect, occasionally running over her 
time from a few days to several weeks, it is almost valueless 
as a symptom. If on the other hand she has always been 
prompt and regular, sudden suppression is almost a posi- 
tive sign of pregnancy. The state of the mind sometimes 
exercises a demoralizing effect upon the nervous system, 
and in that way delays the commencement of the flow. 
This may occur with young married women who are very 
averse to raising children, and consequently in mortal dread 
of becoming pregnant. It may exercise a still greater in- 
fluence upon unmarried women who have rendered them- 
selves liable to become pregnant. In either case the 
influence is equivalent to a severe fright and may delay 
the menstrual flow for several days. 

Another symptom of pregnancy which is of great impor- 
tance, is nausea and vomiting, which is commonly called 
"morning sickness." This symptom is familiar to most 
married women. The sickness usually comes on soon 
after rising from bed in the morning. Like the sickness 
from taking morphine, it is provoked by the erect posture. 
It sometimes commences within a day or two after con- 
ception, but more commonly is deferred to the third or 
fourth week. It usually ends during the fourth month. 
It is sometimes mild, causing but very little inconvenience, 
and at other times so severe as to threaten the life of the 
patient. In extreme cases it is necessary to bring about 
premature delivery to save the life of the mother. Asso- 
ciated with the morning sickness or existing independently 
of it, are frequently other disorders of the stomach, such 
as acidity, heartburn, flatulence, and sour eructations. 

Salivation often accompanies the sickness of the stomach 



PREGNANCY. 287 

in severe cases. It may also occur in the form of drivelling 
saliva when there is no morning sickness at all. 

Facial neuralgia and toothache are liable to characterize 
the state of pregnancy during the early weeks. This ten- 
dency seems to run in families. Sometimes all the girls in 
a family are affected in this way as soon as they get married 
and commence raising children. Where heredity is a 
strong predisposing cause to toothache and neuralgia dur- 
ing pregnancy, the occurrence of those affections may be 
regarded as almost positive evidence of the pregnant con- 
dition. 

The mammary glands or breasts commence a gradual 
enlargement soon after conception occurs, and about the 
same time there are often darting pains in the region of 
the nipple. Sometimes, however, it is only an itching or a 
burning. The nipples are also enlarged and surrounded 
by a dark ring called the areola, which is especially dark 
in brunettes. 

The bladder affords another important symptom of 
pregnancy during the first month on account of pressure 
it receives from the womb, being diminished in its capacity 
to hold urine, and rendering frequent urination necessary. 
This in connection with other signs of pregnancy is a very 
convincing symptom. During the second month there is a 
natural anteversion or tipping of the womb forward upon 
the bladder, further lessening its capacity to hold water, 
and increasing the frequency of urination. Early in the 
fourth month the pressure upon the bladder is relieved by 
the womb rising out of the pelvis into the cavity of the 
abdomen. 

Quickening is the symptom occasioned by decided move- 
ments of the child, and commences about the middle of 



288 FEMALE DISEASES. 

pregnancy. Where conception takes place during lacta- 
tion, and before menstruation is established after the pre- 
vious pregnancy, there is no reliable means for determining 
the commencement of pregnancy. In such cases quicken- 
ing, which commences about the middle of utero-gestation, 
affords the only information regarding the time at which 
the child will probably be born. Therefore, if the time of 
birth is set four and a half months after the first appear- 
ance of quickening, the calculation is liable to be correct 
within one or two weeks. 

Management of Pregnancy. 

Unfortunately for mankind in general and especially for 
the mothers of our race, the first pregnancies occur at a 
time when the ignorance of both husband and wife, re- 
garding the care and necessities of the pregnant state, is 
most profound. For this reason the young husband, 
utterly unaware of an abnormal or nervous condition 
that may exist, thoughtlessly neglects his wife, or fails 
to be responsive to her cravings for love and tenderness. 
This may lead to desperate despondency, or to the devel- 
opment of an excitable and intensely irritable state of the 
mind. When to her morbidly sensitive, nervous, and 
mental state, are added disorders of digestion, morning 
sickness, constipation of the bowels, sour stomach, and 
an uncontrollable desire for articles of diet least suited to 
her condition, it is apparent that pregnancy, the most im- 
portant period in the life of a woman, requires the exercise 
of all the intelligence, care, patience, love, and forbearance 
possessed by both husband and wife. Granting that the 
foregoing is true, this question naturally arises : In what 
does the 



PREGNANCY. 289 



Hygiene of Pregnancy 

mainly consist^ or, in other words, what is the best man- 
agement of pregnancy? For her own sake and that of her 
offspring as well, every pregnant woman should be made 
as comfortable, cheerful, and happy as the circumstances 
of her husband, and her general environments will permit. 
The unfavorable business and pecuniary affairs of the 
family should never reach her mind. She should be 
carefully shielded from everything that is mentally de- 
pressing or annoying. If inclined to melancholy, she 
should not be left alone. Correcting disorders of diges- 
tion, and providing her with the companionship of pleasant, 
congenial people, may overcome all despondencies. 

She should be encouraged to indulge freely in the walks, 
talks, and general pleasantries of life, including social 
games. If inclined to literature in any form, her taste in 
that direction should be encouraged, as whatever is men- 
tally satisfying and pleasing is, on general principles, cal- 
culated to benefit her and her unborn child. If she wishes 
to do housework, it is much better for her to be so em- 
ployed than to sit with folded hands, and muse pensively 
upon her prospects of motherhood. 



EFFECTS OF THE MOTHER'S MIND UPON 
HER UNBORN CHILD. 

It is well known that disgusting or frightful scenes that 
violently affect the mind of the pregnant female are liable 
to exert a morbid influence upon the unborn child, so as to 
dwarf and deform its physical and mental growth. 



290 FEMALE DISEASES. 

Thousands of cases are upon record showing that idiocy, 
deformities, and human monstrosities have been traced to 
impressions made upon the minds of mothers before giv^ 
ing birth to children. How emotional impressions can 
affect the mind, the facial expression, and physical con^ 
tour of a child that has never seen the light of day, is 
hard to tell. Interspersed with the matter of this mate- 
rial world is a realm of mysterious, unknown, and perhaps 
unknowable, forces. The matter is objective and tangible, 
while the forces are, for the most part, but dimly sensed. 

There are millions of sights that we cannot see ; millions 
of sounds that we cannot hear ; millions of forces that we 
cannot feel ; millions of tastes to which our natural organs 
are insensible ; millions of perfumes reaching us upon the 
wings of the viewless air, that we cannot smell ; there are 
millions of life germs spreading diseases from ocean to 
ocean, that only the most powerful microscope can reveal; 
and there are millions of maternal influences — weird, 
mysterious, and inconceivably delicate — connected with 
the impregnation of the human germ and its lodgement 
and growth in the womb, that we cannot understand. 

The writer knows that he once lived in a dark, narrow 
chamber, the womb, where he was peculiarly nourished 
and slightly conscious, and believes that the mind and 
emotions of a loving mother moulded his plastic, prenatal 
brain and organism so as to endow him at birth with the 
capacity for physical and intellectual development that has 
mainly determined his destiny in life. How this was done, 
is at best a matter of conjecture. 

When a wound is made in the flesh, there is a rush of 
blood to that locality, carrying fibrinous lymph, the neces- 
sary material for healing the wound, and an active, adhe- 



PREGNANCY. 29 1 

sive inflammation is set up. If the injury is extensive, the 
inflammation will be correspondingly so, and the demand 
for fibrine is liable to be greater than the normal blood can 
supply. Nature, as if fully aware of the deficiency of 
healing material in the blood, creates an extra amount of 
fibrine with which every ounce of blood is enriched, and 
in that way the wound is reenforced with fibrinous lymph 
or repairing material, and the healing process hastened. 

When a woman in the early months of pregnancy takes 
up a difficult line of study, such as mathematics, for ex- 
ample, and pursues it every day for months, there is an 
increased flow of blood to the brain to supply the waste 
caused by such long-continued mental taxation. As the 
mental labor has a tendency to use up certain chemical 
constituents of the blood, is it not logical to suppose that 
nature will recognize the draught made upon the blood in 
this way, and enrich it with an abundance of suitable ma- 
terial to supply the waste in the brain ? 

It is obvious, if the blood is made excessively nutritious 
to supply the waste in the brain tissue occasioned by 
severe mental exercise, that it is in the best possible con- 
dition to contribute to brain growth. 

As the mother and her unborn infant are nourished by 
the same blood, it seems that the brain growth of the 
child in the womb must be to a great extent commensu- 
rate with the mental exercise of the mother. 

If she should apply herself vigorously to the study of 
music, there would be an increased flow of blood to her 
head to supply the waste of brain substance, but such 
waste would not be the same as that caused by mathe- 
matical studies, and conservative nature would add to 
the nutritive qualities of the blood an abundance of ele- 



292 FEMALE DISEASES. 

ments needed to meet the draught made upon it by the 
study of music, only. 

This blood would nourish the unborn child, and there- 
fore contribute to the development of the same organs 
that had been exercised by the mother. 

If true that certain mental pursuits cause the brain to 
draw from the blood certain chemical properties, it is also 
true that nature must meet the demand made upon the 
blood by increasing the amount of the much-needed ele- 
ments, and therefore it seems possible for a mother to 
bestow upon her child a superior mental capacity by the 
manner in which she employs her mind and body during 
the nine months preceding its birth. 

Evolution is the ruling principle, and highest natural 
power of the universe. In all the countless worlds that 
are teeming with living beings, the order of development 
is doubtless from the lower to higher forms of life. This 
is natural. Man is the dominating intelligence of this 
planet, as there is no other being that approaches him in 
intellectual capacity. He has conquered everything that 
breathes or inhabits the deep, and made the whole moving 
world of life subservient to his imperious will. After fight- 
ing ferocious beasts for thousands of centuries, and thread- 
ing his way through the bewildering mazes of the past, he 
has finally made our little world a suitable dwelling-place 
for refined, intelligent people. 

But in the realm of the unseen, unheard, unfelt, and 
unknown, he has a thousand worlds, as it were, yet to con- 
quer. As he has but recently attained a state of mental 
development, rendering him capable of unfolding and util- 
izing a few of the possible millions of natural forces, it is 
reasonable to infer that he is yet in the childhood of his 
intellectual growth. 



PREGNANCY. 293 

If this is true, the most important question of coming 
centuries is the evolution of mankind. From the infancy 
of the human race, man has been groping his way upward 
in search of intellectual light, and it is believed that his 
greatest blunder is, and ever has been, his failure to under- 
stand the main laws and conditions that affect, for good or 
ill, his mental growth. 

Experience has taught that the kindergarten method of 
teaching young children — a method in which the mental 
unfoldment of pupils depends mainly upon object lessons — 
strengthens both body and mind, renders children exceed- 
ingly precocious, and early in life lays a broad and solid 
foundation for the more difficult studies of schools and col- 
leges. The reasons are obvious. The little ones are put 
under suitable training when the brain is as soft and pliable 
as putty, the best of lessons are taught, and every child is 
carefully shielded from bad influences. 

A child is probably a thousand times more susceptible 
to good or bad impressions during its earliest development 
in the womb than it is after becoming a kindergarten pupil, 
and experience and statistics almost warrant the opinion 
that the womb of every pregnant woman is practically a 
miniature kindergarten in which the mother's object les- 
sons are impressed upon the mind of the unborn. 

Granting that this is true, we are compelled to admit the 
existence of a multiplicity of conditions connected with the 
subtle forces and functions of maternity that we can 
neither explain nor fully understand. Oh, what a library we 
should need in which to record the things of this world 
that no one knows ! For every mystery that science has 
solved, she has discovered a hundred new ones. She has 
found a few precious and glittering gems along the surf- 



294 FEMALE DISEASES. 

beaten shore, but the great ocean of truth that she surveys 
with her tireless and wistful eyes, is unexplored. 

The objective and tangible forces of nature, such as 
steam, fire, wind, and wave, we understand and can usually 
avoid, but unfortunately the subjective, intangible, and 
inconceivably fine forces are the most powerful in their 
effects, for weal or woe, upon humanity. 

It is now generally admitted by the highest medical 
authorities that structural alterations of the growing child 
in the womb may be caused by unfavorable mental influ- 
ences upon the mother, and that human monstrosities 
generally occur in this way. Physiologists agree, and 
observations abundantly prove, that the emotions of the 
mother affect the physical development, bodily form, and 
facial expression of her child. They also agree that men- 
tal growth may be arrested or retarded in a similar way, 
causing idiocy or an enfeebled mental condition. For 
these reasons the best authors, in considering the manage- 
ment of pregnancy, advise every patient to be carefully 
protected from frights, physical shocks, and all sudden 
news of an unpleasant nature. 

It is pleasant to know that these ideas that were instilled 
into the minds of young people by the intelligent mothers 
of thirty or forty years ago — ideas that were stigmatized 
by the doctors of those days as "old women's whims" 
— have been recognized during the closing years of this 
most progressive and eventful century as an important part 
of the scientific literature of medicine. 

The sprout of an acorn in coming up through a soft 
and yielding soil, is not swerved from a direct course, and 
therefore appears above the surface as a straight and per- 
fect scion. If not injured by accident, it will become the 



PREGNANCY. 295 

monarch of the forest, and after withstanding the storms 
of a thousand winters will be as straight as an arrow. But 
if, in coming out of the ground, it is bent in its tender and 
delicate fibres by a stone or unyielding clod of earth, it 
appears above ground more or less crooked and deformed, 
and can never make a perfect tree. 

The acorn is an impregnated vegetable germ. The earth 
in which it is planted and to which it firmly attaches itself, 
is the womb. The length of time that it is planted before 
making its appearance, is its period of gestation or growth 
in the womb. This may be from two to four weeks, ac- 
cording to the amount of moisture, character of the soil, 
and other conditions, and yet in this short time the fate of 
the majestic oak, as regards shape and beauty, is deter- 
mined. If two or three weeks of unfavorable conditions 
will dwarf, deform, and ruin a tree that might other- 
wise live and grow for a thousand years or more, the 
importance of the period from conception to the birth 
of a child in determining its destiny, is hard to over- 
estimate. 

If a woman is kept in a state of mental irritation by a 
drunken or otherwise obnoxious and worthless husband 
during pregnancy, or if vexed and tormented in other 
ways, her poor child is no more to blame for being bad 
than a tree is to blame for being crooked. 

Oh, what a sacred temple is the maternal womb in which 
are nourished and developed the mind, body, and spirit of 
a human being ! What infinite possibilities await the pli- 
able, receptive mind of the infant whose mother is favored 
with suitable environments during the nine months previ- 
ous to its birth ! 

Every industry, every enterprise, every school and col- 



296 FEMALE DISEASES. 

lege, and everything else in this world that approaches the 
goal of perfect success, must be established and conducted 
upon settled and definite principles. These are facts that 
the leaders of industry, science, literature, and art fully 
recognize. The telescope thrills us with the grandeur of 
a hundred million suns ; the artist's pencil gives body and 
soul to color, light, and shade ; the magnet conducts us 
safely across the bosom of the deep to the islands of joy 
and rest ; and that subtle, imponderable force — electricity 
— brings us news from every country under the sun. 
Why ? Simply because the principle and power of the 
telescope have been studied and practically mastered ; 
painting is taught in well established schools of art where 
all the colors, delicate lines, shades, and expressions of the 
subject are carefully worked out; navigation has become 
a fixed and definite science ; and electricity is governed by 
laws that are thoroughly understood. But unfortunately 
for man — the dominating intelligence of the globe — the 
laws relating to human reproduction, to the natural, crea- 
tive forces through which the world has been peopled, are 
yet shrouded in mystery. 

When the effects of the mother's mind and body upon 
the unborn are properly studied, the world will begin to 
realize that the best time to commence the education of 
a child is nine months before it is born. Then its intel- 
lectual growth — the growth upon which its taste, mental 
capacity, and success in life largely depend — will begin 
to receive the attention that the cause of human happiness 
and progress demands. Then the management of preg- 
nancy will be reduced to a thorough system, as everything 
that is successful must be. Under this regime, parents 
will have some idea of the inclinations and capabilities 



PREGNANCY. 297 

of their children, and will not compel them to take up lines 
of study for which they have no taste. 

Then the question of blooded people will receive quite 
as much attention as that of blooded horses, blooded cattle, 
or blooded dogs. 

When a boy keenly enjoys mathematics or anything 
else, it is because he has a natural ability to succeed and 
be equal, if not superior, to those of his class. A solitary 
half hinge is one of the most worthless things on earth, and 
therefore conservative nature never makes one half with- 
out making the other. For the same reason she does not 
create in any boy a taste for a certain line of study or 
work without endowing him with a capacity to succeed, 
and in almost all cases success depends upon his fondness 
for his work, whatever it may be. 

The best things of this world have been slow in their 
development, because man has been slow in his own mental 
unfoldment. A few centuries ago, muscle was considered 
the Archimedes screw through which to move the world. 
Then a man never was considered a hero until he had 
measured his strength with some mortal foe and conquered. 
It was then that women — even pregnant women — en- 
joyed feasts of blood, and exultingly clapped their hands, 
like Mrs. Fitzsimmons, when their favorite vanquished his 
enemy in the arena of mortal strife. 

Then, naturally enough, the world was filled with bullies, 
thugs, and face-beaters. Then physical conflict was an 
essential part of the pabulum upon which the mothers of 
humanity lived and flourished, and men took to fighting 
naturally because the minds of their mothers dwelt upon 
that subject previous to their birth. 

That was a fighting age. Men, women, and children 



298 FEMALE DISEASES. 

were in constant danger of being destroyed by wild beasts, 
and the necessities of the times made fighters of every 
one. Husbands and wives fought each other, their sons 
and daughters fought among themselves, and young 
men frequently courted their sweethearts with a club. 
Then it was only the strong in bones and muscles that were 
considered fit to survive. Men like Corbett and John L. 
Sullivan were the idols of those days and fairly represented 
the ideas of the people regarding the " survival of the fit- 
test." But over fifty years ago the calcium light of genius 
entered the dark places of earth with a Yankee inven- 
tion that thoroughly discouraged the big-fisted manglers 
of human anatomy. 

This established a physical equality among men, so far 
as fighting was concerned, and since that time, brain, 
instead of muscle, has been at a premium. 

The inventor's name was Colt, and although never 
praised as a benefactor to posterity, his death-dealing 
revolver was a world-civilizer, and did what the schools, 
courts, and churches could not do — broke up fighting 
among men. 

This showed the superiority of mind to brute force, and 
turned the admiration of the world from physical strength 
to genius. 

When it was found that a man, however strong he might 
be, could not become famous with his fists in the face of 
a six-shooter, parents ceased in their efforts to raise bullies, 
because the world had no use for them. 

Women became less inclined, gradually, to admire men 
in consequence of their great physical achievements, and 
turned their thoughts, tastes, and affections in the direc- 
tion of mental refinement and superiority. 



PREGNANCY. 299 

The invention of the revolver was the unfoldment of 
a thought that has placed the world upon a favorable basis 
for an intellectual development that will go on forever. 

The correct principles of evolution — of human develop- 
ment — consist in producing good people with brilliant 
minds, by a logical system of breeding, just as fine, high- 
bred animals are produced. 

However refining and beneficent religious teachings may 
be, they cannot make honest, reliable people out of persons 
who are naturally thieves. To be "born again" may im- 
prove those who are brought into the world under condi- 
tions that compel them to be impure in their thoughts and 
more or less depraved and dishonest in their dealings and 
conduct with the world, but it is a thousand times better to 
have them born right the first time, and then the second 
birth, about which so much has been said, will be un- 
necessary. 

MORNING SICKNESS. 

One of the most obstinate and annoying complications 
of pregnancy is the sickness that often comes on every 
morning, immediately after rising from bed, or sometimes 
just after breakfast. Sometimes the sickness is mild in 
character, only occurring once in twenty-four hours, and that 
soon after getting out of bed in the morning. In other 
cases the vomiting occurs only after the morning meal, the 
breakfast usually being thrown up. Occasionally the sick- 
ness of pregnancy comes on within a few days after concep- 
tion, but as a general thing it does not commence until the 
third or fourth week. 

There is every degree of morning sickness as regards 
severity. In some cases all food, of whatever character, 



300 FEMALE DISEASES. 

is thrown up as soon as swallowed. In such cases the 
smell of food may cause deathly sickness. The nausea of 
pregnancy is very much like seasickness, and is also like 
the sickness caused by taking a full dose of morphine, the 
vomiting in the three conditions being hastened by the 
erect posture, and due mainly to similar causes, that is, to 
complete arrest or derangement of digestion. 

Morning sickness has been considered from time imme- 
morial a sympathetic disorder, in which the stomach sym- 
pathizes with the congested womb. The writer is very 
much inclined to the opinion that this theory is only par- 
tially true, as he has found that the sickness yields 
promptly to a remedy that he has found to be a specific in 
atonic dyspepsia. As the treatment that almost always 
cures atonic dyspepsia breaks up the sickness from preg- 
nancy so promptly and permanently that it proves to be 
a specific in such cases, it affords strong grounds for the 
opinion that the " morning sickness " is mainly, if not 
wholly, due to a form of dyspepsia peculiar to the pregnant 
state. In pregnancy there is a foolish and morbid craving 
for articles of food that are exceedingly hard to digest and 
therefore injurious. The same tendency manifests itself 
in many dyspeptics, showing that the unnatural appetites 
in both cases are probably due to similar causes, and in- 
stead of catering to such diseased tastes, it is far better to 
correct the conditions of the stomach, bowels, and the 
nervous system upon which they depend. 

Treatment. — There are three very important things to 
consider with reference to treatment. First. Give her the 
kind of food that is nourishing and most easily digested. 
Second. Until her sickness is overcome she should take 
her meals and medicine while lying in bed with her head 



PREGNANCY. 301 

and shoulders slightly elevated. Third. The drug that is 
calculated to stimulate digestion and in that way stop 
sickness, should be given a half hour before eating, and 
but little fluid of any kind taken until meal-time. The 
following is the remedy for a lady weighing from one 
hundred to one hundred and seventy-five pounds : Give 
a half-grain pill of extract of ignatia before each regu- 
lar meal. If she eats four times in twenty-four hours, and 
the meals are at least four hours apart, she may take a 
pill at each meal until the nausea and vomiting are 
stopped, but, as a rule, three pills in twenty-four hours 
are sufficient, even if more than three meals are taken. 
This drug does not stupefy the brain and nerves as mor- 
phine does, and therefore does not relieve the sickness 
like an opiate, but gradually corrects the morbid condition, 
which is indigestion, and stops the sickness permanently. 
It is not a palliative remedy at all. It has no direct ten- 
dency to relieve the sickness. It does not quiet and 
stupefy the nerves, but arouses them to greater activity, 
so they stimulate the organs of digestion and cure the dys- 
pepsia of pregnancy upon which the sickness generally 
depends. 

Under this course the sickness generally ceases in two 
or three days, and often within twenty-four hours, but in 
rare cases it may have to be given for a week before the 
sickness is entirely overcome. 

One pill should be given three times a day for a month 
after the sickness has ceased. Persons weighing over one 
hundred and seventy-five pounds should take the three- 
quarters of a grain pill, and they must in all cases be 
coated with sugar or gelatine. Those weighing over two 
hundred should take a one-grain pill. The use of opium 



302 FEMALE DISEASES. 

in any form, or any other remedies that quiet the irrita- 
bility of the stomach by putting the nervous system to 
sleep, should not be tolerated in sickness from pregnancy, 
as such remedies arrest digestion and increase the trouble. 
For the sour stomach there is nothing better than bicar- 
bonate of soda, and that is nothing more than the common 
baking soda. Put a heaping teaspoonful in a half glass of 
water, and give her a swallow of it whenever she has 
heartburn. As long as there is acid in the stomach, the 
soda can do her no harm, as the fight is entirely between 
the soda and acid. The soda destroys the acid in the 
stomach and the acid destroys the irritating effect of the 
soda. 

CONSTIPATION OF THE BOWELS. 

With many women constipation during pregnancy ap- 
pears to be natural. In such cases it is not a disease, but 
a physiological condition depending upon pregnancy, and 
limited in its duration to the pregnant state. It is a con- 
dition, however, that requires considerable attention, and 
yet it is best to avoid if possible the use of physic of every 
kind ; not that a moderate physic is liable to cause an 
abortion or to do any harm to the unborn ; but the terrible 
sluggish state of the bowels lasts for many months, and is 
more aggravated than benefited by physic, as the tendency 
of every cathartic is to lessen the vigor and deaden the 
sensibility of the entire intestinal tract. Therefore the 
treatment of constipation should be in almost all cases 
hygienic. 

A profusion of fruits of every kind, excepting berries 
with small seeds, should be eaten every day. In addition 
to apples either baked, fried, or stewed at meals, several 



PREGNANCY. 303 

may be eaten raw during the day, while oranges, peaches, 
and bananas may also be used freely. By leaving off 
meat in a great measure, and adopting a fruit diet thus 
lavishly, the constipation of pregnancy grows beautifully 
less and often disappears entirely. 



PILES IN PREGNANCY. 

One of the most provoking complications arising from 
costive bowels and consequent straining at stool during 
pregnancy, is the development of piles. The best way to 
avoid them is to use a syringe before each movement of 
the bowels, and inject into the rectum about a pint of warm 
water. This will soften the stool so it will pass easily, and 
in that way the necessity of straining will be avoided. Of 
course, when the constipation is overcome by a fruit diet, 
injections are not needed. 



ENLARGED VEINS. 

Enlarged and knotty veins of the thighs and legs occur 
in almost all pregnancies, but usually disappear after the 
birth of the child. They are due in a great measure to 
obstruction of the veins by pressure, preventing a free 
flow of the blood upward to the heart, but the trouble is 
also increased by constipation. The same obstruction that 
causes the veins of the lower extremities to enlarge also 
enlarges the veins of the anus, causing piles, which are 
simply enlarged and multiplied blood-vessels. The obstruc- 
tion, the tendency to piles, and enlargement of the veins of 
the thighs and legs, are all increased by constipation. 



304 FEMALE DISEASES. 

Treatment. — If the knotty veins become large so as to 
be in danger of rupturing, it is best for the patient to wear 
elastic stockings, so as to firmly support the veins and pre- 
vent further expansion of the walls. After the rupture of 
a vein has occurred the situation is more complicated, as 
there is an open wound that needs attention. It may soon 
become an ulcer, soiling the elastic stocking, and rendering 
its frequent removal necessary. Therefore it is far better 
to properly support enlarged and knotty veins, so as to 
avoid all risks of bursting a vein. If the expanded veins 
are almost wholly below the knee, a short stocking, reach- 
ing a little above the knee, will be sufficient, but if the veins 
of the thighs are also enlarged, the stockings should ex- 
tend clear to the body. They can be bought of almost 
any house dealing in surgical instruments. The cotton- 
elastic stockings will cost about five dollars per pair, pos- 
sibly a little more. The silks will cost nearly twice as 
much. In many cases only one stocking is needed. 



SLEEP. 

Every pregnant woman should be permitted to enjoy 
an abundance of quiet, restful, health-restoring sleep, and 
for this reason she should not be burdened at night with 
the care of children. 



CLOTHING. 

All garments should be suspended from the shoulders, 
so as to absolutely avoid pressure upon the chest and 
abdomen. 



PREGNANCY. 305 



COITION. 

If this is enjoyed by the pregnant woman, moderate 
sexual indulgence will do her no harm. If distasteful to 
her it ought not to be tolerated. She should be the sole 
arbiter upon the question of intercourse during the entire 
term of pregnancy. 



NURSING SORE MOUTH. 

This is one of the most distressing diseases from which 
a woman is liable to suffer during pregnancy, or while 
nursing her child, and as usually treated is as obstinate as 
it is painfully annoying. It may commence soon after 
conception, or it may not set in until after the child is 
born. It often affects the lower side of the tongue, the 
mucous membrane becoming red and inflamed. The first 
symptom is usually a smarting pain from swallowing hot 
tea or coffee. The tendency of the inflammation is to 
increase and also to spread and involve other parts of the 
mouth. Sometimes it causes the worst form of sore throat 
and ends fatally. 

Causes. — The predisposing cause is heredity, as it 
"runs in families," and is mainly due to a blood taint of 
some kind. Women of scrofulous parents are especially 
liable to it. It also occurs frequently among women sub- 
ject to rheumic disorders such as eczema. The exciting 
causes are pregnancy and nursing. 

Treatment. — The disease should never be allowed to 
kill a patient, because there are three ways to get rid of it, 
one of which is always sure. 
x 



306 FEMALE DISEASES. 

The first is to give the following as soon as the disease 
commences : — 

Iodide potassium, two drachms, 
Syrup stillingia co., one pint. 

Mix, and give a tablespoonful three times a day. This 
will usually cure a case in a week or ten days. If, 
however, the case is neglected or badly treated, until the 
patient is approaching a dangerous condition, the ques- 
tion of premature delivery must be considered if it is due 
to pregnancy. If due to nursing, the child should be 
taken from the breast and the milk dried up as soon as 
possible. This will be followed by prompt recovery. In 
a very extensive experience with this disease, the writer 
has only found one case in which the drug treatment 
failed to effect a cure. In this case, the patient was in 
the sixth month of pregnancy, and died before the remedy 
had time to be of any benefit to her. 

A local treatment, such as ordinary mouth washes, is 
almost entirely useless, but it is very important to avoid 
hot drinks, liquors, or any irritating drinks whatever. 

DURATION OF PREGNANCY. 

Pregnancy ends with the birth of the child, and its 
duration is about two hundred and seventy-five days, 
dating from the last occurring menstruation. For many 
reasons it is exceedingly important to know about what 
time the birth of a child is liable to occur; and in the 
absence of positive information as to when conception 
takes place, there is nothing so reliable as the rule that 
fixes the time at two hundred and seventy-five days after 
the last day of the last menstruation. 



PREGNANCY. 307 

Unfortunately, however, conception frequently occurs 
while the mother is nursing, and before the menstrual 
flow suppressed by the previous pregnancy has returned. 
In such cases, the best way to get an approximate idea as 
to when the birth is liable to occur, is to place the time 
at a hundred and thirty-five days after " quickening." 
This will usually be within two or three weeks of the 
correct time. During a long and extensive practice in 
midwifery, the writer kept a record of many cases in 
which the date of conception was positively known, and 
in all such cases the duration was within a few hours of 
two hundred and seventy days. 



SEX OF THE OFFSPRING. 

The opinion prevails somewhat extensively among the 
laity of this country, that where conception occurs soon 
after the cessation of the menses, the child will be a girl, 
and that if it occurs a week or more later, it will be a boy. 
In this calculation, it is supposed that if conception occurs 
in about four days after the cessation of the flow, the child 
is about as liable to be of one sex as the other. As far as 
the observation of the writer extends, the rule holds good, 
but unfortunately his experience is limited to less than a 
dozen cases. 

SIGNS OF LABOR. 

As this is not a work on midwifery, it is not necessary 
to describe the phenomena of labor, nor to allude to its 
various stages ; but in order that every prospective mother 
may be on her guard and avoid being left alone and help- 



308 FEMALE DISEASES. 

less at a critical time, it is thought best to give the pre- 
monitory or warning symptoms of labor. 

In the first place, every pregnant woman should know 
the date of her last monthly period, and by counting 
forward two hundred and seventy-five days from the last 
day of the flow, she will usually be within two or three 
days of her time to be sick; and this, if nothing more, 
should be a warning to her and her husband. 

In addition to this, the precursory signs of labor, con- 
sisting of a discharge of mucus streaked with blood, set in 
within from one to three days before true labor. This is 
called the " show," and is accompanied by trifling pains in 
the back and abdomen. Sometimes real labor follows 
these warning symptoms within a few hours, and this is 
especially liable to occur with women who have borne 
children, and therefore the physician who has been en- 
gaged to attend the case should be called. 

CHLOROFORM AND ETHER IN LABOR. 

Millions of intelligent women bear testimony to the 
fact, that among all the agonizing, torturing pains that 
have ever afflicted mankind, the suffering of childbirth 
holds a front rank. Regarding the truth of their state- 
ments on this subject, there is no question. It should be 
the object of every physician, not only to save the lives of 
men, women, and children, but to prevent, as far as possible, 
human suffering, to accomplish the greatest amount of 
good in the world with the least possible pain. There is 
no more excuse for allowing women — the best part of the 
human family — to writhe in the agonies of childbirth for 
hours, than there would be for strapping a man to a table 



PREGNANCY. 309 

and amputating a limb without ether or chloroform. Many- 
objections to the use of chloroform in labor have been 
brought forward. They are all too absurd and groundless 
to be mentioned. It is a fortunate thing for the present 
generation, that the great physicians of thirty or forty 
years ago, who foolishly opposed the use of ether and 
chloroform in labor, are dead, and that a higher, wiser, and 
better civilization has in a great measure adopted what 
they condemned. The writer has given chloroform hun- 
dreds of times in labor and never had any bad effects from 
it. In all cases labor seemed to proceed as regularly and 
rapidly as if it had not been given, while at the same time 
the patient was almost free from pain. In recent years 
he has used ether instead of chloroform, and it is hard to 
imagine a case in which a physician with any intelligence 
would be liable to do any harm with it. The short and 
sharp pains in the early stages of labor should be borne 
without ether, but by the time the mouth of the womb 
opens to the size of a silver dollar, it may be given and 
kept up until the birth of the child. The hard and forcing 
pains come on an hour or two before the " waters break," 
and are especially severe from the time the water escapes 
until delivery, and during this time the patient should have 
an abundance of ether so as to be almost free from pain. 
Where she is in her first confinement, and the pains are 
violent and rapid, giving but little time for the soft parts 
to dilate, it is best to give enough ether to modify the bear- 
ing down effort, and prolong the labor a half hour or more, 
so as to lessen the danger of rupturing the soft parts. At 
this stage of labor the patient will bear a great deal of 
ether before the voluntary, expelling effort is checked to 
any extent. 



310 FEMALE DISEASES. 

It is hard to think of a case in which ether is capable of 
preventing the mortal anguish that it does in childbirth, 
especially if labor is severe, and every woman should have 
it, after the hard, forcing pains come on. She should see 
her doctor personally before her sickness and get his 
promise to give her ether. It is a very poor town that 
does not have more than one good physician, and if one 
will not give her ether another one will. The drug does 
no harm either to the mother or the child. 



CONCEPTION, AND WHEN IT IS MOST 
LIABLE TO OCCUR. 

Conception takes place when the living seed of the 
male is implanted in the female germ. The germ thus 
impregnated or fertilized is called an ovum, and as to 
where it is at the time of impregnation, is still a matter of 
some doubt, and is of little interest except from a scientific 
standpoint. The time at which conception is most liable 
to occur, is usually a matter of the greatest importance to 
young married people, and they are entitled to all the in- 
formation that can be given them on that subject. 

An ovum, which is the Latin word for egg, is matured in 
one of the ovaries at the time of menstruation, and at the 
cessation of the menstrual flow is in suitable condition to 
be impregnated, but the length of time that it remains in 
the organs of generation after menstruation ceases, is lim- 
ited, and in many cases is only a few days. Therefore con- 
ception is most liable to occur immediately after the 
flow ceases, and the liability gradually diminishes from 
that time on. 

In a report of thirty-five thousand conceptions that 



PREGNANCY. 3 1 * 

appeared in a medical work a few years ago, the greatest 
number were about the fourth day after menstruation 
ceased. The number of conceptions decreased rapidly 
from the fourth to the tenth day, there being less than one 
hundred on the latter date. Five cases occurred on the 
twelfth day, two on the thirteenth, and none after that 
date. From the foregoing it seems that less than one 
in a hundred occurred after the tenth day and none after 
the thirteenth. Therefore it appears that the cases in 
which conception occurs after the twelfth day dating from 
the cessation of the monthly flow, are exceedingly rare, 
being only one in thirty-five thousand. 



CAKED BREASTS AND SORE NIPPLES. 

One of the most frequent and painful annoyances affect- 
ing mothers while nursing their first infant, is, first, 
inflamed nipple, second, " caked breast," third, abscess of 
the breast. The trouble usually develops in the order 
named, and the inflamed and cracked nipple is responsible 
for the coagulated milk, inflammation of the breast gland, 
and the abscess. It occurs in this way : the babe irritates 
the tender nipple by nursing. As it becomes inflamed the 
milk-duct is more or less obstructed by lymph, requiring 
greater suction by the babe or a breast pump to get the 
milk out. The mother cannot endure the torture neces- 
sary to empty the breast. The coagulated milk causes 
inflammation of the breast, and abscess follows. 

Treatment. — It is best to commence the treatment 
before the child is born. The main point in preventing 
trouble consists in elongating or drawing out the nipples 
every day with the thumb and finger. This can be done 



312 FEMALE DISEASES. 

by the patient's mother, sister, husband, or herself. In 
addition to drawing them out with the thumb and finger, 
they should be bathed every day and rubbed with a cloth 
dipped in cold water. This treatment will almost always 
prevent sore nipples, and in so doing will prevent abscess 
of the breast if reasonable care is exercised. The treat- 
ment acts favorably in three ways. First. By drawing 
out the nipple so the babe can easily hold it in its mouth. 
Second. By making the nipple harder, tougher, and less 
liable to irritation. Third. By getting the young mother 
accustomed to having her nipples somewhat roughly 
handled, she is better prepared for the suction necessary 
to empty the breasts and prevent " caking " of the milk. 
If, however, the nipples become the least inflamed, they 
should be treated immediately by applying the following, 
two or three times per day : — 

Tannin, one drachm, 

Glycerine, water, of each a half ounce. 

Mix. 
Should the nipples be inflamed and cracked, the follow- 
ing is better : — 

Zinc ointment, one ounce, 
Carbolic acid, one-half drachm. 
Mix, and apply night and morning. 
The nipples must be carefully cleaned with soap and 
warm water in either case before allowing the babe to 
nurse. 



DANDRUFF. 313 

DISEASES OF THE SKIN. 
Dandruff. 

Other names : seborrhoea ; pityriasis ; acne sebacea. 

This is a functional derangement of the fat glands of 
the skin in which there is an unnatural amount of fatty- 
matter secreted that discharges itself upon the skin in the 
form of a greasy coating, and sooner or later forms itself 
into crusts and scales. 

Causes. ■ — There are various theories regarding the ori- 
gin of this affection, but there is no positive information 
on the subject, the cause of the disease being unknown. 

Symptoms. — The disease may occur upon any and 
every portion of the body, but it is most frequently found 
on the face and scalp. Seborrhoea oleosa is that form of 
the disease that appears on the face as a greasy coating. 
It is unattended with any congested condition of the skin 
and does not itch as in the scaly variety, but gives a 
greasy, untidy appearance to the features that is very an- 
noying. In bad cases the oil stands in drops on the fore- 
head and cheeks. This form is called seborrhoea of the 
face and nose. 

Seborrhoea sicca is a form of the affection in which the 
greasy coating dries up, more or less, leaving scales upon 
the skin, and is attended with intense itching. When it 
occurs upon the scalp it is called seborrhoea capitis, which 
means grease of the head or a greasy condition of the 
scalp. When these scales or crusts have become some- 
what dry, they separate from the scalp and are combed out 
in the form of dandruff, and the patient is constantly try- 
ing to comb them all out; but the diseased condition is 



314 DISEASES OF THE SKIN. 

constant, a new crop of scales is always forming, and the 
dandruff remains unchanged. 

Termination. — The trouble is very obstinate and a per- 
fect cure not often possible, but under the right treatment 
the condition of the patient can be so modified that he 
will suffer but little inconvenience from the affection. 

Treatment. — The first thing of importance is to act 
upon the glandular system, and for this purpose take the 
following : — 

Iodide potassium, two drachms, 

Simple syrup, one pint. 
Mix ; dose, a tablespoonf ul three times a day. It would 
be well to follow this treatment for three months. When 
the scales upon the scalp are dry, and they usually become 
so, the hair should be cut short, and the head rubbed hard 
and long with vaseline or sweet oil so as to soften the 
scales and cause them to separate from the scalp. The 
head should be covered with a cap of oiled silk at night so 
as to protect the pillow. In forty-eight hours after the oil 
is applied in this way, wash the head with the following 
mixture : — 

Strong soapsuds, twelve ounces, 

Alcohol, four ounces. 
Mix. The long and gentle application of this by rub- 
bing will remove all the grease and detach all the scales, 
after which the head should be combed with a dull comb 
so as to avoid wounding the scalp. 

After this, the following stimulating and healing applica- 
tion will be of great importance and may effect a cure : — 

Corrosive sublimate, eight grains, 

Pure brandy, one-half pint. 
Mix, and apply to every part of the scalp, once per day, 



DANDRUFF. 315 

with a small sponge. The application should be made 
gently, as rubbing is unnecessary, wetting the affected 
parts being all that is needed. If with this treatment, 
conjoined with the iodide of potassium, the case is not 
greatly improved in two months, the iodide of potassium 
should be left off and Fowler's solution given as follows : 
Fowler's solution, two drachms, 
Water, four ounces. 
Mix, and give a teaspoonful three times a day. 

If, after everything is done that can be, the dandruff still 
continues to be very annoying, falling out in dry white 
scales on the clothing, the following, used two or three 
times a week as occasion requires, will almost entirely stop 
the dandruff from falling out : — 

Glycerine, four ounces, 
Alcohol, twelve ounces. 
Mix, and shake. 

This can be rubbed into the scalp and hair with the 
hands, and the way in which it prevents the dandruff from 
falling out upon the clothing is easily understood. The 
alcohol thins the glycerine so as to make its application 
easy, and allow it to spread over the entire scalp and also 
coat every hair in the head. Within a few hours after it 
is used, the alcohol evaporates, leaving the thin film of 
glycerine upon each hair, and also upon the scales that are 
commonly called dandruff. Now when these scales sepa- 
rate from the scalp, they stick to the hair instead of shower- 
ing down upon the clothing. When a fine comb is used 
they stick to the teeth, and in this way can all be combed 
out. The use of this preparation three times per week, 
with reasonable care in the use of a comb, will keep almost 
any head of hair practically free from dandruff. 



316 DISEASES OF THE SKIN. 



ACNE. 



Other names : varus ; acne vulgarus. 

This is a chronic inflammation of the fat glands of the 
skin, attended with pimples or pustules, and confined mainly 
to the face and neck. 

Causes. — The affection usually commences at the 
period of manhood or womanhood and may continue in- 
definitely. The predisposing cause is heredity, as it 
frequently runs through an entire family of children. 
Disorders of digestion is one of the most frequent of all 
the exciting causes. 

Symptoms. — To put it in the plainest possible language, 
acne is a disease in which the face, forehead, and neck are 
more or less covered with pimples, some of them being 
small and flat, others pointed and containing fluid, while 
some others may contain pus. The flat form of the 
pimple is called a papule, the one containing fluid a 
vesicle, while the one with pus is called a pustule. 

This is an affection of the skin that absolutely ruins the 
appearance of thousands and thousands of both sexes. 
In many cases the eruption is very red, is attended with 
more or less suppuration, rendering the skin disgustingly 
uncleanly, and almost every one so afflicted has exhausted 
the medical skill and patience of the neighborhood in 
which he lives in order to get cured, and yet in nineteen 
cases out of twenty has neither been cured nor materially 
benefited. With young ladies the case is simply desperate, 
as that upon which the hopes and happiness of every 
woman largely depends is her beauty, and this is totally 
destroyed by the eruption. It appears that but few things 
can bring joy to the hearts of more people than the dis- 



ACNE. 317 

covery of a remedy or certain form of treatment that will 
always cure this affection. Such a remedy has been dis- 
covered, has been used by the author for a great many 
years, and is published for the first time in this book. 
It is applicable not only to this disease, but many other 
chronic affections of the skin, and is as follows : — 
Corrosive sublimate, six grains, 
Brandy, one pint. 

Mix, and take a teaspoonful before each meal. The fol- 
lowing is to be used as a face wash once per day, and 
applied with a small sponge : — 

Corrosive sublimate, eight grains, 
Brandy, a half pint. 

Mix, and apply with a small sponge to every part of the 
face upon which there is any eruption, using great care to 
avoid getting it in the eyes. It will take many months to 
entirely cure a bad case, but improvement will commence 
within a few weeks. In the worst case ever treated by 
the author, both remedies were used for ten consecutive 
months. In this case a young lady who was so disfigured 
by the eruption that she had to wear two veils, was com- 
pletely cured, and became one of the prettiest women of 
the city. In much milder cases a cure can be effected in 
a couple of months. But the one general advice to all is 
to follow the treatment until the patient is cured, as it 
always succeeds finally. In extreme cases that have 
lasted for years, it sometimes requires three months to 
make a decided impression upon the eruption. 



318 DISEASES OF THE SKIN. 



WENS. 

Other names : sebaceous tumors ; encysted tumors. 

A wen consists of a morbid condition of a fat gland of 
the skin, and its accompanying duct in which the walls, 
both of the gland and duct, are greatly expanded and con- 
verted into a sack that is filled with a brown colored fluid, 
somewhat thick, sometimes jelly-like, and in other cases 
consisting of doughy matter. 

Causes. — Entirely unknown. 

Symptoms. — Wens come on slowly, and are generally 
found on the scalp, but frequently occur on the shoulders 
and back, and sometimes upon other parts of the body. 
They are generally round or nearly so, and range in size 
from a buck-shot to a small orange, the largest usually 
being on the back. They are painless tumors unless 
irritated by pressure or friction. 

Treatment. — This is easy and simple, and consists in 
opening the sack freely with a sharp knife or lance, and 
emptying it of its contents. The next thing is to remove 
the sack, and the best way to do it is to get hold of it with 
the finger and thumb, carefully work it loose, and extract 
it whole if possible. When this is done the wen is forever 
destroyed. In the small wens affecting the scalp they can 
be opened with a lance, the fluid pressed out, and the 
little sack filled with two or three drops of the strongest 
solution of chromic acid. This will entirely destroy the 
sack so it will never refill. 



EXCESSIVE SWEATING. 319 



EXCESSIVE SWEATING. 

Other names : hydrosis ; hyperidrosis. 

This is a derangement of the sweat glands attended 
with an increased flow of perspiration. It may be either 
local or general. 

Causes. — In the majority of cases the cause of the affec- 
tion cannot be determined. 

Symptoms. — When this disease occurs during an acute 
disease such as rheumatism, pneumonia, in the advanced 
stage of consumption, etc., it has no reference whatever to 
the disease under consideration, for in such cases it is 
merely one of the symptoms of an acute affection. 

When the perspiration has the odor and chemical char- 
acteristics of urine, to some extent, it is called uridrosis. 
When the drops of respiration appear luminous in the 
dark it is called phosphoridrosis. When profuse sweating 
occurs locally it generally affects the palms of the hands, 
the feet, armpits, the anus, and external sexual organs. 
Excessive perspiration of the feet is the most disagreeable 
feature of the disease, as the socks become bathed in per- 
spiration, acting as a constant poultice upon the foot, caus- 
ing the outside skin to peal off, leaving the inner skin so 
tender as to interfere with walking. In addition to this, 
the feet give off a sickening odor that is almost unendur- 
able. When the affection attacks the genital organs of 
the male, as it sometimes does, it imparts a disagreeable 
odor, to get rid of which frequent bathing is necessary. 

There are a great many cases that do not yield to any 
treatment. 

The parts should be thoroughly washed and dried with 



320 DISEASES OF THE SKIN. 

a good towel. Then one of the best preparations as a 
dusting powder is the following : — 

Salicylic acid, two drachms, 
Tannin, one drachm, 
Prepared chalk, four ounces. 
Mix, and make into the finest possible powder, and ap- 
ply it with a puff. 

For the profuse sweating of the feet they can be bathed 
every morning in the following : — 

Tannin, two drachms, 
Alcohol, two ounces, 
Water, six ounces. 
Mix, and rub the feet freely, and especially the soles 
and between the toes with a sponge dipped in this solu- 
tion. The feet should be thoroughly cleansed with soap 
and warm water before using the tannin in this way. 
After this has been used for a few mornings, use the fol- 
lowing dusting powder in the socks : — 
Tannin, one-half ounce, 
Powdered starch, four ounces, 
Powdered soapstone, eight ounces. 
Mix thoroughly, and apply to the soles of the feet and 
between the toes with the puff, and dust freely into 
the socks. It is claimed that a saturated solution of 
boracic acid, applied once a day to the parts affected, will 
cause an absolute cure. 

To make a saturated solution, put all the boracic acid 
in water that it will dissolve, and a little more, then shake 
it well before using it. 



CONGESTION OF THE SKIN. 321 

CONGESTION OF THE SKIN. 

Another name is erythema simplex. 

This is an acute disease in which the vessels of the skin 
are more or less engorged with blood, assuming a swollen 
and reddened appearance, the color being removed by- 
pressure. As it is a step in the direction of inflammation 
the temperature is generally increased. 

Causes. — It may be produced by anything acting as an 
irritant, for example, sunshine in burning the skin causes 
acute congestion. The application of irritating drugs, 
severe friction, or pressure will have a similar effect. 

Symptoms. — The skin turns red, the color gradually 
increasing until it may become almost purple, and in all 
cases as the color deepens the engorgement of the blood- 
vessels increases. When the irritant producing the con- 
gestion is local, the affection is local also, as a general 
thing. 

Treatment. — Remove the irritating cause as soon as 
possible. To overcome the congested and irritable state 
of the skin, the treatment is easy and simple unless it has 
been caused by a poison. If due to friction, pressure, 
mustard, Spanish flies, the application of heat, or similar 
causes, the congestion will speedily subside when the 
exciting cause is removed. 

One of the best remedies for acute congestion of the 
skin is the following : — 

Sugar of lead, a heaping teaspoonful, 
Water, a pint. 

Mix, and bathe the skin, using a soft cloth, once or 
twice a day. 

Y 



322 DISEASES OF THE SKIN. 

RINGWORM OF THE BODY. 

Other names : tinea circinata ; herpes circinatus. 

This is a contagious disease of the skin caused by the 
presence of a parasite, and appears in irregular, slightly 
inflamed patches upon the body. 

Symptoms. — The affection generally commences by 
the appearance of pimples in patches or clusters which 
sooner or later arrange themselves into circular form, 
giving rise to the familiar name, "ringworm." The com- 
mon size of a ringworm is about an inch in diameter. 
When the disease becomes very chronic it is hard to dis- 
tinguish from salt-rheum. This is especially the case 
when it affects the thighs, and should be treated as the 
chronic form of eczema. 

Termination. — This is always favorable under the cor- 
rect treatment. 

Treatment. — As it is a local affection the application 
to the affected parts of a suitable remedy to destroy the 
parasites is all that is necessary. For this purpose the 
following should be applied to every part of the diseased 
skin : — 

Crystals of chromic acid, two drachms, 
Water, one and a half drachms. 

Mix, and apply with a camel's hair brush. If the part 
of the body affected by the ringworms is covered with 
hair it must be closely clipped. If a great deal of surface 
is involved, it is not well to treat it all at one sitting, or 
even during the same day ; but as a general thing it is 
proper to apply the solution to all the diseased surface at 
the same time. In the very chronic form, in which the 
circular or ringworm characteristics have disappeared, 



RINGWORM. 323 

the corrosive sublimate treatment, as advised for chronic 
eczema, may be substituted for the chromic acid. The 
formula is as follows : — 

Corrosive sublimate, eight grains, 
Brandy, a half pint. 
Mix, and apply once per day with a camel's hair brush. 
Before using this the skin must be washed thoroughly 
clean, as it will do no good if grease or ointment of any 
kind covers the surface. It should be applied at least 
once per day, and as the affection is liable to be compli- 
cated with eczema, the internal remedies for that disease 
must be given also, and are as follows : — 

Corrosive sublimate, six grains, 
Brandy, one pint. 
Mix, and give a teaspoonful three times a day. The 
treatment, both local and constitutional, should be followed 
until the patient is entirely well, even if it takes months, 
which it may require if complicated with eczema. 



RINGWORM. 

Other names : tinea favosa ; porrigo favosa ; favus ; 
crusted ringworm. 

This is a chronic, inflamed condition of the skin, caused 
by a parasite. It is always due to this cause, and is liable 
to affect persons of any age, as it is decidedly contagious. 
It is found mostly among people who are careless and 
uncleanly in their habits. 

Symptoms. — Its commencement is characterized by the 
appearance, usually about the scalp, of small, yellow crusts. 
In a few weeks the crusts increase in size and sink in the 



324 DISEASES OF THE SKIN. 

centre, somewhat like a vaccine scab. They may be few 
in number or very numerous, and about as large as a pea. 

In the early stages of this disease, the yellow color of the 
scabs and their sunken appearance are so very character- 
istic that it is easily recognized. 

Termination. — This is always favorable, and yields read- 
ily to local treatment. 

Treatment. — There is nothing more rational than this : 
If a bug or insect of any kind secretes itself in the skin so 
as to form an inflammatory affection, the first thing to be 
done is to kill it. If there are thousands of them, they 
must all be killed. There is no occasion for constitutional 
treatment in this disease ; it is essentially local in every 
respect, and to attempt to cure it with internal remedies is 
as unscientific as to try to remove a thorn or a splinter 
from the flesh by giving a physic. The following local 
remedy, if properly applied, will cure every case : — 
Chromic acid crystals, two drachms, 
Water, a drachm and a half. 
Mix. 

This is a saturated solution of the chromic acid, and 
should be applied to every crust or scab by means of a 
glass rod or stick dipped in the solution. It is best to 
touch every part of the inflamed skin in this way, and it 
will kill every parasite. When these are killed, recovery 
follows rapidly, and the patient is well within a week. Its 
use is attended with but little pain or smarting. 

If a great deal of the scalp is involved it may not be best 
to treat every part of it at one time ; but cases of this kind 
are rare. Before making the application the hair should 
be cut very short, and great care must be taken to see that 
every part of the diseased skin, whether on the face or 



SALT-RHEUM. 325 

scalp, is painted with the solution. If thoroughly done, 
one application is usually sufficient ; but the diseased parts 
should be carefully examined at the end of a week to see 
if there is any appearance of living parasites, and if so, 
touch the suspicious spots again with the solution. 

SALT-RHEUM. 

Other names : tetter ; eczema ; scall. 

This is an inflammation of the skin, either acute or 
chronic, and may have during its different stages, papules, 
vesicles, and pustules. In the acute stage it is attended 
with burning and tenderness, and, sooner or later, a watery 
discharge from the skin resulting in the formation of crusts, 
and attended with itching. The disease is not contagious. 
A great many different varieties are named in the text- 
books, but they are merely different stages of the malady, 
and to catalogue them here would simply confuse the 
reader. 

Causes. — It is liable to attack persons in all the differ- 
ent walks of life and of any age. There are a great many 
exciting causes that are liable to develop the affection, but 
it is doubtful if any or all of them will produce a well- 
marked case of salt-rheum, in one in whom no hereditary 
predisposition to the disease exists. Among all the affec- 
tions that are directly traceable to heredity, salt-rheum takes 
the lead. Where it is found in one member of a family 
of any size, it is almost sure to crop out in several others, 
sooner or later. Where a train of symptoms attending an 
acute inflammation of the skin is rheumic in character, that 
is, having the characteristics of salt-rheum, they are exceed- 
ingly easy to overcome by treatment if no hereditary ten- 



326 • DISEASES OF THE SKIN. 

dency to that affection exists, and therefore it is very- 
doubtful if such cases as recover with but little if any 
treatment are salt-rheum at all. 

Symptoms. — Salt-rheum is so varied and profuse in its 
forms, stages, and symptoms as to assume the character, 
during the different periods of its development, of several 
other skin diseases, but when it is watched through a 
number of its stages, it is not liable to be confounded 
with other affections. 

It is the most common of all eruptions, and it is proba- 
ble that something near one-half of all the chronic ail- 
ments of the skin are eczema, in some of its many forms 
and stages. Therefore, if a skin disease commences with 
heat, redness, and swelling, attended with a watery dis- 
charge that leaves a crust on drying up, and is further 
characterized by intense itching or burning, it is safe to 
call it eczema or salt-rheum. 

The simplest form is attended with redness of the skin 
in patches, and as a general thing there is no discharge 
from the surface. 

The papular form is that occurring in bright-red or dark- 
red pimples. It is more or less associated with the vesicu- 
lar form to be hereafter described, and is characterized by 
terrible itching. 

The vesicular variety commences with the four principal 
signs of inflammation, namely : heat, pain, redness, and 
swelling, soon followed by the appearance of small vesicles 
containing fluid. When these vesicles or pimples rupture, 
the escaped fluid spreads over the surface and dries up, 
leaving crusts or scales. Itching is the terribly distress- 
ing symptom of this form also. 

The pustular form usually affects the face and head but 



SALT-RHEUM. 327 

mostly the latter, and is characterized by large, thick crusts 
from between which there is frequently an oozing of mat- 
ter. This variety is commonly known by the name of 
scall-head. 

Eczema rubrum is a form characterized by red skin, as 
the word "rubrum" means red. But this variety has no 
symptoms essentially different from other forms. 

The fissured variety is one in which the skin is fissured 
or cracked. Sometimes these fissures are extensive, deep, 
and very painful. They frequently affect the hands, and 
are known by the familiar term, "chapped hands." 

In order that eczema may never be mistaken for any 
other disease, the following condensed symptoms charac- 
teristic of the affection, are given, namely : Inflammation 
of the skin, swelling, redness, a discharge of moisture which 
is folloived by crusting, and itching and burning. If all of 
these symptoms are found in any case, it is eczema, as 
they are practically its autograph. 

Termination. — If properly treated, this is always favor- 
able, as every case ought to be cured, unless it is compli- 
cated with disease of the stomach or other infirmities, by 
which the patient is rendered incapable of taking the 
necessary medicine. 

Treatment. — As eczema is a constitutional disease, and 
undoubtedly of ancestral origin, so far as a predisposing 
cause is concerned, the main treatment should be constitu- 
tional. On whatever part of the body it appears, it writes 
its full name and character by a half-dozen distinguishing 
symptoms that point unmistakably to a blood disease that 
may be centuries older than the patient. 

To suppose that such a condition can be eradicated or 
torn out by the roots in a few weeks, is utter folly. It 



328 DISEASES OF THE SKIN. 

takes months, and sometimes many months, too, to cure a 
bad case ; but the author has had an extensive experience 
with the disease in all its many forms, and has never failed 
to cure any case where he has been permitted to carry out 
the treatment as desired. The two plans of treatment to be 
hereafter given — one for the acute, and the other for the 
chronic — are not experimental. They have been tried in 
a great many cases, and always succeed. The object in 
speaking in such positive terms of the treatment, is to in- 
spire every patient with a degree of confidence necessary 
to follow it long enough to effect a permanent cure. The 
length of time required to cure a case depends, to some ex- 
tent, upon the time the disease has been running. Where 
it has recently broken out, it can be conquered in a few 
weeks with but little if any local treatment. 

If the disease has only existed a few weeks, or even a 
few months, the following should be given immediately, 
and followed until the patient is well : — 

Iodide potassium, three drachms, 

Compound syrup of stillingia, one pint. 

Mix, and give a dessert-spoonful three times per day. 

There are a few, and only a few, rules of caution to be 
observed regarding this remedy. First. Be sure to get it 
put up by a good, reliable druggist. Second. If the patient 
is a child, the dose must be reduced to suit the size and 
age, and in all children under ten years old a teaspoonful 
three times per day will be sufficient. Third. By the time 
the syrup is given a few days, all the symptoms may be- 
come aggravated, the skin being redder, the inflammation 
greater, and the burning and itching more intense. In 
such cases the remedy must be left off for three or four 
days, and then given in a little smaller doses. After it is 



SALT-RHEUM. 329 

given for a few weeks, if no further aggravation follows, 
the dose may be gradually increased to the amount first 
given. It sometimes causes an unpleasant feeling in the 
throat, and also a watery discharge from the nose, as if 
one had a cold; but these annoyances can be easily borne 
when every patient is assured that a permanent cure will 
result in a short time. In the acute form, that is, in cases 
of recent origin, no local treatment is used with a view of 
having a curative effect. A little vaseline gently applied 
to the affected skin will prevent a great deal of the itching 
and burning, and will also keep the crusts or scabs soft. 

In the form of the disease affecting the scalp, the crusts 
are usually large, sometimes more or less loose, and pus, 
or white matter, will frequently make its appearance from 
beneath one when it is pressed. The pus and watery dis- 
charge stick the hair down firmly upon the large scabs or 
crusts, and the whole surface is often of a dirty, yellowish 
green. Such cases frequently resist the ordinary treat- 
ment for several years, first being treated by one physi- 
cian, and then by another, and all to no purpose. But 
although a case may have been running for a few years, 
the disease may be more acute than chronic in its nature, 
and the iodide potassium and syrup of stillingia, as advised 
for the acute form, is the best treatment ; but it will take 
six months, and sometimes longer, to cure cases of this 
kind. Success probably depends more upon the alterative 
and curative effect of the stillingia than upon the iodide 
potassium. Whether this is true or not, the form of 
eczema that affects the scalp as above described, is always 
cured by the mixture if properly given. This variety of the 
disease is commonly termed " scall-head," and is never too 
chronic to be cured with the one general treatment given 



330 DISEASES OF THE SKIN. 

for all acute cases. During the constitutional treatment 
of " scall-head " no local treatment is needed except for 
the purpose of making the patient as comfortable as possi- 
ble. No effort should be made to remove the crusts until 
they are loose enough to drop off, as they afford great pro- 
tection to the inflamed skin beneath. The hair should be 
kept short, and the frequent use of vaseline will prevent 
matting together. 

CHRONIC ECZEMA. 

The generic or original meaning of the word " chronic," 
signifies " of long duration," but in medicine it does not 
necessarily mean " of long standing," as a disease affect- 
ing one person may be acute at the end of a year, while 
the same disease attacking another may be chronic within 
a week or two. Some forms of eczema are more chronic 
than acute in character from the beginning. When it 
comes on gradually, with no active, inflammatory symptoms, 
but is mild and sluggish in its development, it is chronic 
in form, although of recent origin, and must be treated as 
chronic. 

If any local treatment is used in the acute form, it 
should be something to reduce the inflammatory action 
and modify the intensity of the disease. Whatever local 
application is used in the chronic form is to make the dis- 
eased action more violent, and develop in that way a healing 
and, ultimately, a curative effect. Therefore, a local treat- 
ment is always conjoined with the constitutional in chronic 
eczema, the internal remedy being as follows : — 

Corrosive sublimate, six grains, 

Brandy, one pint. 



CHRONIC ECZEMA. 33 1 

Mix, and give a teaspoonful before each meal. 

This mixture must be taken for months, or until the 
patient is entirely well. 

The local treatment to be applied at least once per day 
is as follows : — 

Corrosive sublimate, eight grains, 
Brandy, one-half pint. 

Mix, and apply once per day with a soft brush, a camel's 
hair brush being preferred. It is rarely if ever needed in 
"scall-head," or in the suppurative form, the variety in 
which matter is discharged from beneath the scabs. Such 
cases are cured with the idodide potassium and stillingia, 
and where the syrup mixture is used, the corrosive subli- 
mate and brandy should neither be given nor used locally. 

There are many forms of eczema in which the skin is 
very red and tender, and the affected parts have to be 
covered constantly to avoid the chafing effects of the air. 
This is especially the case when one or both hands are 
diseased. 

Sometimes a hand is wrapped up for years in this way 
with salt-rheum, and is red, painfully tender, more acute 
in character than chronic, and stubbornly resists all ordi- 
nary efforts in the way of treatment. The corrosive 
sublimate remedies, as herein advised, will cure all such 
cases within six or eight weeks. Improvement will be 
apparent within a week or so, and the cure will be perma- 
nent ; but it may take months for the skin to lose the 
unnatural color. In almost all forms of eczema, except 
" scall-head," the corrosive sublimate mixtures are preferred 
to the iodide potassium and stillingia whenever the patient 
can comfortably bear the application of the local remedy, 
as the cure is much more rapid from the two mixtures 



332 DISEASES OF THE SKIN. 

of mercury and brandy than from the syrup and iodide, 
the cures being permanent in both cases. 

Sometimes two or more diseases of the skin affect a 
person at the same time, the symptoms being so confusing 
that it is impossible for a specialist in skin affections to 
know what particular form of skin disease he is treating, 
and he is, therefore, compelled to proceed on general 
principles, and cure his patient if he can. 

The remedies prescribed in this chapter will cure other 
forms of skin disease besides eczema, provided the symp- 
toms are somewhat similar. Then, again, about one-half 
of all the chronic affections of the skin are eczema in some 
form, so that a non-professional, should he call every erup- 
tion of the skin he sees, eczema, would be right about half 
the time. Therefore : — 

To fathers, mothers, sisters, and brothers, 
Uncles, aunts, cousins, and others, 
the following advice is given : When you encounter a skin 
disease that you cannot possibly name, carefully read the 
chapter on eczema, including the treatment and if you 
find symptoms somewhat similar to those of eczema in any 
of its stages, treat the affection accordingly, and if you 
cure a disease and do not know its name nor much of its 
peculiar character, you simply do what we doctors are 
compelled to do many, many times every year we practise 
medicine. 



THE ITCH. 333 

THE ITCH. 

Another name is scabies. 

This is a highly contagious disease caused by the loca- 
tion of little animals in the skin, and is attended with an 
eruption that usually involves most of the body except the 
head, neck, and face. The eruption has three stages : First, 
the papule or pimple, when it first begins to make its ap- 
pearance ; second, the vesicle, when the pimples are rilled 
with fluid ; third, pustules, when pus or matter is present 
in the pimples. The little parasites burrow into the skin, 
causing inflammation and intense itching, to relieve which 
the patient is seized with an irresistible desire to scratch ; 
this tears the top off the vesicle or pustule, causing more 
or less bleeding, and greatly changes the appearance of the 
affection. 

Termination. — This is always favorable if properly 
treated. 

Treatment. — No internal remedies are needed in the 
treatment of itch, as it is purely a local affection. The 
following ointment will cure every case if the directions 
are carefully followed : — 

Venice turpentine, three drachms, 
Powdered sulphur, one ounce, 
Vaseline, three ounces, 
Carbolic acid, one drachm and a half, 
Oil citronella, one drachm. 

Mix, and rub thoroughly over every part of the body ex- 
cept the face and head, applying it at bedtime. On the 
following night apply it again in the same way, and the 
next night wash thoroughly with very warm water and 
castile soap so as to remove every part of the ointment, 



334 DISEASES OF THE SKIN. 

and then put on clean underclothes. Common lard may- 
be used instead of the vaseline if desirable, and is quite as 
good in every way. 



BARBER'S ITCH. 

This is a contagious affection of the skin due to a para- 
site, and involves the roots of the whiskers. It is a very- 
contagious disease, and is said to be communicated to 
gentlemen by the barber while they are being shaved, the 
infecting parasite being transferred to the skin by a brush 
or sponge. 

Symptoms. — This form of itch begins as scaly patches, 
the affected skin being reddish and gradually becoming 
more inflamed and thickened. As the inflammatory ac- 
tion increases, the skin becomes thicker and lumpy with 
points of suppuration. The pain, itching, and burning are 
very severe in some cases. 

Treatment. — The first thing to be done is to clip the 
beard as short as possible, and put a poultice of flaxseed 
meal on the face and allow it to remain all night. In the 
morning remove the poultice, and wash the face with cas- 
tile soap and warm water, carefully removing all crusts or 
scabs if it can be done without making the face bleed. 
Then touch all the diseased portions of the skin with a 
solution of chromic acid, made as follows : — 
Chromic acid, two drachms, 
Water, one drachm and a half. 

Mix, and apply with a camel's hair brush, using it spar- 
ingly so it will not spread to parts not touched with the 
brush. If this is properly done one application will be 
sufficient to effect a cure. If it attacks a person with 



FRECKLES. 335 

heavy whiskers, and there are serious objections to having 
them clipped close so as to allow the chromic acid solution 
to be properly applied, the following can be used instead, 
and will usually effect a cure : — 

Corrosive sublimate, ten grains, 
Brandy, one-half pint. 
Mix, and rub it into the skin thoroughly wherever the 
disease exists. If thoroughly applied it will kill the para- 
sites, and recovery will soon follow. 

FRECKLES. 

Another name is lentigo. 

This is a dark or yellowish deposit in the skin, showing 
itself in the form of yellow specks that are sometimes as 
large as a pea. It is most observed on the face, neck, and 
hands, because those parts of the skin are most exposed to 
the sun and air. 

Causes. — The predisposing cause is hereditary and the 
main exciting cause is sunshine. 

Termination. — So far as permanent cure is concerned, 
this is not very favorable unless the patient is protected 
from the sun. 

Treatment. — This affection becomes very serious when 
the blotches are large and deeply colored upon the faces 
of young ladies, and efforts are constantly made to bleach 
out the spots by the use of various drugs recommended 
for such purposes. It seems the best remedies that have 
ever been found are only successful to a limited extent. 

In all diseases the most important thing to be done is to 
get rid of the exciting cause, and this is especially true 
with freckles. Therefore the only rational plan that can 



33^ DISEASES OF THE SKIN. 

yield anything like satisfactory results is for every person 
who is constitutionally inclined to have freckles, to veil 
their faces from the sun. The following local application 
enjoys the reputation of being one of the very best to re- 
move freckles : — ■ 

Corrosive sublimate, six grains, 

Diluted muriatic acid, two drachms, 

Alcohol, two ounces, 

Glycerine, one ounce, 

Water, a half pint. 
Mix, and apply at bedtime, taking great care to avoid 
getting it in the eyes. It should be washed off next morn- 
ing with soap and warm water. 

CHALK-LIKE DEPOSITS IN THE SKIN. 

This affection has a great many other names that are 
decidedly technical and unnecessary to mention here, and 
consists of a deposit of cheesy matter in the duct of a fat 
gland of the skin, the mouth of such duct, for some reason, 
being permanently closed. The white deposit is there- 
fore imprisoned, and shows through the thin, overlying 
skin as a small piece of chalk. These little lumps range 
in size from small bird-shot to a large grain of wheat, and 
are usually seen about the eyes, upon the eyelids, and just 
below the eyes. 

Termination. — This is always favorable. 

Treatment. — This consists in opening the sack, holding 
the substance with the point of a sharp knife, or picking 
it open with a needle and squeezing its contents out. 
After this if the sack should refill, it should be emptied in 
exactly the same way, and then touched with a saturated 



hives. 337 

solution of chromic acid. This should be used very 
sparingly, as the head of a pin will hold enough when 
crowded into the opening to destroy the sack. Opening 
the sack with a needle or lance is almost entirely free from 
pain. 

HIVES. 

Other names : nettle-rash ; urticaria. 

This is an inflammation of the skin accompanied with 
numerous round elevations of the surface, being somewhat 
deeper in color than the surrounding skin. For example : 
The skin may be a light pink while the circular elevations, 
known as hives, are a deeper red, and attended with burn- 
ing, itching, and stinging. 

Causes. — Hives prevail more extensively in hot weather, 
scarcely causing any trouble during the fall, winter, and 
early spring. It can therefore be accepted as a rule that 
the heat of summer is the principal exciting cause. As all 
affections of the skin are influenced, more or less, by dis- 
orders of digestion, the condition of the stomach must be 
considered in dealing with hives. 

Symptoms. — Hives are known by the sudden appear- 
ance of rounded elevations upon the surface of the skin, 
called wheals, which are frequently whitish to commence 
with, and later becoming pinkish or a deeper red. The 
color, no doubt, is frequently deepened by rubbing or 
scratching to allay the itching. 

The most distressing feature of this affection is the 
terrible itching. The wheals are usually small, not much 
larger than a half pea, but sometimes are as large as an 
egg. They may be very few in number, while in other 
cases they cover the entire body. 
z 



338 DISEASES OF THE SKIN. 

Treatment. — To relieve the distressing itching, the hives 
should be bathed in a strong solution of baking soda. 
About two heaping teaspoonfuls of the soda to a glass of 
water will probably answer, but should it fail to allay the 
itching, it must be made strong enough to cause a little 
smarting of the skin, when the itching will cease. 

Another very efficient local application to stop the itch- 
ing is the following : — 

Carbolic acid, a tablespoonful, 
Water, one pint. 

Mix and shake. Dip your finger in the solution, and 
wet every itching wheal by touching one at a time. If 
they are numerous, the surface involved may be wet by a 
sponge or soft cotton cloth dipped in the solution. They 
must neither be scratched nor rubbed, as anything that 
irritates the skin greatly increases the trouble, especially 
the itching. 

Stimulants of every kind, including tea and coffee, should 
be left off. The following is one of the best remedies to 
break up an attack of hives : — 

Salicylate of soda, two drachms, 
Water, four ounces. 

Mix, and take a teaspoonful every two hours for twenty- 
four hours. Then give the following mixture until there 
are free watery discharges from the bowels : — 
Epsom salts, 
Cream of tartar, of each an ounce. 

Mix thoroughly, and take a heaping teaspoonful in a 
half glass of water every three hours until it commences 
to act on the bowels. During an attack of hives it is 
best to use every possible means to avoid heating the 
blood, and, therefore, the clothing should be very light, 



BLACK-HEADED WORMS. 339 

and exercise in the heat of the day should be avoided. 
Should the patient resort to bathing to quiet the burning 
and itching, the water should be a little warm, as the 
reaction from a cold bath greatly aggravates the affection. 

BLACK-HEADED WORMS. 

Other names : acne punctata nigra ; comedo. 

This is a disordered condition of the fat glands of the 
skin, in which there is retained in the duct of each gland 
a resinous, cheese-like secretion, having in its centre a 
black point. When this obstructed duct is squeezed be- 
tween the thumb and finger nails, the cheesy substance, 
crowned with a black head, comes out and turns over 
upon the skin, presenting the appearance of a worm the 
eighth of an inch long or more, and for this reason the 
affection is usually known as black-headed worms. 

Causes. — The only thing sure in reference to the cause, 
is that it runs in families, and is therefore due to an 
inherited predisposition. 

Symptoms. — This is a chronic derangement of the skin 
unattended by irritation, itching, or any other unpleasant 
symptom except disfiguring the features of the patient, as 
the mouth of each excretory duct of the skin may be a 
black speck, giving a person the appearance of having 
been burnt with powder. 

Termination. — Under proper treatment this is usually 
favorable, but many cases are tedious and troublesome. 

Treatment To begin with, the disorders of the stom- 
ach and bowels, if any exist, should be corrected. The 
local treatment consists in poulticing the face over night 
with bread and milk or flaxseed, and washing thoroughly 



340 DISEASES OF THE SKIN. 

in the morning with soap and water, and rubbing the 
so-called worms out of the skin with a Turkish towel. 
Those that cannot be rubbed out can be pressed out with 
the thumb nail. After this, the application of zinc oint- 
ment once per day will be of great service to prevent their 
return. It may be continued for a week. 

CARBUNCLE. 

Another name is anthrax. 

This is a circumscribed inflammation, the skin and 
tissues involved being thickened, hardened, of a dark red 
color, and very painful. 

Causes. — It most frequently occurs after the meridian of 
life, but its real cause is unknown. 

Symptoms. — To commence with, it is usually a circular 
inflammation rising somewhat above the surrounding parts 
like a boil, and taking on a dark red or purple color. 
Sometimes the inflammation is deep and extensive in all 
directions. The pressure from congestion and deposits of 
lymph partially arrest the circulation, causing more or 
less destruction of the central part of the carbuncle by 
gangrene. There may be several of these points in which 
death of the tissue has occurred. These form openings 
through which matter is permitted to escape. As the 
disease progresses, these numerous openings may honey- 
comb the whole central part, leaving but little living flesh 
between the openings. The affection is attended with 
severe throbbing pain, loss of appetite, coated tongue, and 
the usual symptoms of inflammation. Its duration is from 
two weeks to two months, and its favorite location seems 
to be the back of the neck. 



CARBUNCLE. 34 1 

Termination. — This is not always favorable, as blood 
poisoning is frequently a fatal complication. 

Treatment. — The diet should be nutritious, consisting 
of beef, chicken, or mutton broth, and all the good animal 
food that the patient may desire. As a tonic, the follow- 
ing is probably as good as can be given : — 

Fluid extract of Peruvian bark, 

Fluid extract of wild-cherry bark, 

Of each, six drachms, 

Sulphate of iron, thirty-two grains, 

Port wine, one pint. 

Mix ; dose, a tablespoonful before each meal. 
After the flesh of the carbuncle is mostly destroyed by 
a number of pipes that are connected only by thin walls, 
there is no quicker, better, and safer plan of treatment 
than to cut the whole honeycombed portion out, leaving 
on all sides a wall of inflamed flesh. The operation is 
easy, simple, and almost painless. For this purpose the 
writer has always used curved scissors similar to those 
used by an oculist in taking out an eye. In order to do 
this without giving ether, the walls of the pipes embracing 
the central and main part of the carbuncle are wet with a 
strong solution of carbolic acid so as to turn them white. 
By this means, clipping the tissues that separate the open- 
ings from each other is practically painless, and the opera- 
tion is attended with no hemorrhage to speak of. When 
it is all removed, leaving the walls of the carbuncle sound 
and free from any dead tissue, the cavity may be packed 
with absorbent cotton wet with a five per cent solution of 
carbolic acid. This course greatly lessens the danger 
from blood poison, and recovery sets in immediately. 
The cavity gradually fills up with granulations, and the 



342 DISEASES OF THE SKIN. 

scar does net seem to be increased much, if any, by the 
operation. 

FLESH-WORM DISEASE. 

Other names : trichinae ; trichina spiralis ; pork worm. 

This is a condition of fever caused by the pork worm 
entering the stomach and bowels, and meandering, sooner 
or later, into other parts of the body, especially the mus- 
cular structure. It is attended with severe irritation of 
the stomach and bowels, soreness of the muscles, and a 
typhoid type of fever. 

These worms gain entrance to the human body by the 
use of hog's flesh in the raw or imperfectly cooked state 
as food. The intestinal pork worm, which is fully matured 
in its sexual organs, is from one eighteenth to one eighth 
of an inch long, the longer ones being the female. Seen 
under the microscope they appear about as large and long 
as a fine cambric needle. As the author remembers them, 
after the lapse of several years, they look like a miniature 
snake, the head being enlarged, and the neck somewhat 
slender. They propagate by eggs. 

Symptoms. — These are greatly modified by the number 
of worms in the affected food. It is claimed by good 
authority that a cubic inch of pork may contain eighty 
thousand of the parasites. 

The intestinal stage of the disease is that during which 
the worms are in the stomach and bowels, and is attended 
with nausea, vomiting, and liquid diarrhoea. The symptoms 
are grave or mild, according as the number of worms are 
many or few. 

The second stage is the one during which the worms 
travel to other parts of the body, and invade the muscular 



CHAFING. 343 

tissue. This stage is attended with fever, somewhat ty- 
phoid in character, thirst being great, tongue and lips dry, 
face red and swollen, with great soreness of the muscles. 

Encysted stage. — This is the stage of the affection in 
which the parasite locates himself, and ceases to migrate, 
a cyst or small sack forming around each one of them. 
In this way the ravages of the worms upon the flesh are 
stopped. If the number that have invaded the muscular 
structure are comparatively few, recovery may occur during 
this stage. 

The mortality depends almost solely upon the number 
of worms in the pork, but, on the average, from twenty- 
five to fifty in a hundred die. 

Treatment. — The prevention consists in eating no pork 
that has not been thoroughly cooked. If the infected meat 
has been recently eaten, a thorough emetic should be given 
so as to have it expelled from the stomach. A large physic 
of castor oil should also be given to carry them out of the 
bowels. After they leave the stomach and bowels their 
prostrating effects on the system is readily apparent, and 
stimulants and tonics should be resorted to. 



CHAFING. 

The technical name of this very common affection is 
erythema intertrigo. 

It is a congested or inflamed condition of the skin, caused 
usually by friction of the opposite parts of the body, and is 
specially troublesome in hot weather among fleshy people. 

Causes. — It is an annoying affliction confined mainly to 
fat people, and caused by chafing of the opposing skin 
surfaces in walking. In such cases it is usually between 



344 DISEASES OF THE SKIN. 

the thighs or buttocks. It also occurs under the arms, and 
is then due, in a measure, to perspiration and rubbing of 
clothing. 

Symptoms. — Redness and soreness of the opposing sur- 
faces of the skin, caused by the movements of the body, 
the parts affected being the groins, armpits, beneath the 
breasts of females, or any other parts of the body where 
undue friction occurs from the folds of the skin coming in 
contact with each other. 

Treatment. — The affected parts should be washed thor- 
oughly with soap and warm water and carefully dried, then 
dusted with powdered starch, soapstone, or prepared chalk. 
There is scarcely anything better than powdered starch, 
which can be applied with the fingers or a puff. In ad- 
dition to this it is important to keep the opposite surfaces 
separated by the use of lint or absorbing cotton. The latter 
is of great service in separating the buttocks, where persons 
are exceedingly fleshy. Where the chafing has developed 
an inflammatory condition, it is better to wash it thoroughly 
clean in soap and warm water, and use the following lotion 
at bedtime : — 

Sugar of lead, a heaping teaspoonful, 

Water, a pint. 

Mix. 
The parts should be thoroughly washed in the morning, 
and gently dried with a soft towel, and then some one of 
the favorite dusting powders applied freely. Common flour 
is a good substitute. 



warts. 345 



WARTS. 



The technical name is verruca. 

A wart consists of a morbid or unnatural excrescence upon 
the skin, and may be as small as a pin head or as large as 
the end of a finger. They are due to an unknown cause. 

Symptoms. — The common wart is familiar to almost 
every person, their favorite location being upon the hands 
and fingers. There are many strange things in connection 
with this form and the manner of getting rid of them. 
There are two drug treatments known to the author, one 
of which will remove a great many warts without causing 
any inflammatory action whatever. The remedy is sal 
ammoniac, and is applied by wetting it with saliva and rub- 
bing it on the wart once per day, causing it to disappear in a 
couple of weeks. It may be that this treatment would 
remove all of the common form of warts, if kept up long 
enough. A gentleman who undertook this treatment upon 
a large wart on his finger, applied it once just before start- 
ing on a long journey. He forgot his remedy and deferred 
further treatment till his return, several weeks later. On 
getting home he got the crystal of sal ammoniac to com- 
mence the treatment again, but could not find the wart. 
This treatment is painless, and should have a thorough 
trial before using severer remedies. A treatment that never 
fails to destroy any wart, if applied for a sufficient number 
of times, is chromic acid, as strong as it can be made. 
The solution is prepared by putting a drachm of the crys- 
tals in the least amount of water that will dissolve them, 
which is probably about the weight of the crystals. The 
application of the drug turns the wart black, hard, and dry, 
and it finally falls off, leaving an inflamed surface that soon 



346 DISEASES OF THE SKIN. 

heals. There are a great many curious remedies for warts 
that nobody can explain nor have any idea of the manner 
in which they operate. For example : Some persons are 
especially gifted as wart doctors, and by wetting their finger 
with saliva and touching the wart, always cause it to dis- 
appear. When the author was a boy, he knew a man who 
had this peculiar faculty, and gratuitously removed warts 
from the hands of all the boys and girls in the neighborhood 
by simply wetting the wart with saliva, and repeating 
some meaningless rigmarole of words. Another plan 
very popular in the country is to go to an old hollow 
.stump partially filled with stagnant water, and wash the 
hands covered with warts every morning for a week, walk- 
ing round the stump three times each morning. It seems 
this is usually successful. It is probable that the curative 
value of all such methods, including wetting the warts 
with saliva, depends upon the influence that the treatment 
has upon the mind of the patient. 

Verruca filiformis is the long, slender character of warts 
found on the face, eyelids, neck, and inside of the thighs. 
These warts are from the eighth to a quarter of an inch 
long, and are easily removed by tying a thread around 
them, making the knot double so it will not slip. The 
wart turns black and drops off in forty-eight hours, the 
treatment being almost wholly unattended with pain. 

CORNS. 

Another name is clavus. 

Unfortunately, almost every one who has worn shoes is 
keenly aware of the character and sensitive nature of a 
corn, and therefore a description of the horny and painful 
thing that afflicts so many people is unnecessary. 



corns. 347 

Causes. — Corns are always caused either by pressure or 
friction, and in almost all cases by pressure from tight 
shoes or boots. 

Treatment. — As the principal cause is a tight-fitting 
boot it must be changed for one that is soft and easy. 
Something depends upon the character of the leather as 
well as the fitting. If this is coarse, heavy, and more or 
less unyielding it may cause a corn, even if the shoe is 
abundantly large. In order to remove a corn it is best to 
soak it for half an hour in hot water to which has been 
added a few ounces of hartshorn. After this most of the 
corn may be scraped off easily with a dull knife. If this 
is followed up about twice a week for a couple of months 
the corn will almost entirely disappear. And during all 
the time of treatment it is well to wear a corn-plaster ring 
to avoid pressure from the shoe. Where a corn is very 
large and troublesome it is best to have a shoe made with 
the special object of protecting it from pressure. In such 
a case a shoemaker who understands his business will put 
a bunch upon his last, considerably larger than the corn, 
and exactly corresponding to the location of the latter 
upon the foot. In this way the leather never contracts 
sufficiently to bear much if any upon the corn, which 
gradually grows less. 

Soft Corns. — These occur between the toes, and the 
best way to get rid of them is to soak them for a long 
time in warm water in which a little caustic potash has 
been dissolved. It should be as strong as can be borne 
without smarting of the skin. After this the foot must be 
thoroughly washed in soap and water, wiped dry, and the 
corn picked out with the point of a dull knife. 

All such corns, as well as hard corns that are painful 



348 DISEASES OF THE SKIN. 

and tender, should be treated night and morning with the 
following liniment until the soreness disappears : — 

Strong spirits of ammonia, 

Olive oil, 

Spirits of turpentine, of each, one ounce. 
Mix. Previous to applying this, every corn should be 
dressed down as thin as possible with a sharp knife, care 
being taken to avoid making it bleed. 

INGROWN TOE-NAILS. 

This is a condition of the toe-nail in which the edges 
have grown down into the flesh. There are two main 
causes of the trouble : One is narrow-toed or badly fitting 
shoes that press upon the outside of the nail of the great 
toe, so as to change its direction and drive it down into the 
flesh. The other cause, and a very frequent one too, arises 
from the bad way in which the nail is trimmed. If this 
is done with a knife, and part of the nail cut off of the 
edge instead of the end, it destroys the shape of the nail, 
and causes it to send its sharp and unnatural edge into the 
flesh, causing great pain and soreness. This bad manage- 
ment in the matter of trimming increases the nail de- 
formity until the person cannot get round without great 
inconvenience. 

Treatment. — This is easy and simple, and yet it may 
take a few months of proper management to get the toe- 
nail back to an easy, natural condition. In the first place, 
in order to avoid running the knife too far up the edges 
of the toe and in that way removing some of the nail from 
each side, it is best not to use a knife at all in cutting the 
nail. The main thing is to cut the nail square across or 



INGROWN TOE-NAILS. 349 

nearly so, and if it is done with scissors it is almost impos- 
sible to do it any other way, and if they are so trimmed 
for a number of months, the nails will become much less 
inclined to turn down as the corners project, so as to rise 
above the flesh instead of going into it. Another impor- 
tant treatment, however, must be conjoined with correct 
trimming in order to get the deformed nail in a natural 
condition. This consists in carefully scraping the horny 
edge until it is quite thin so it will easily bend, then lifting 
it with the point of a dull knife and pressing a small tuft 
of cotton under it. This raises the edge of the nail and 
changes its direction so it grows over the flesh instead of 
into it. In such cases it is best to wear a tuft of cotton 
under the nail for several months, scraping the edge of 
the nail now and then if necessary. When the foot is 
washed the old tuft can be taken out, and a clean one in- 
serted in its place. It is hard to imagine an ingrown toe- 
nail so terribly distorted, horny, and refractory as to 
require removal by the surgeon's knife, and yet the oper- 
ation is frequently performed, and, unhappily, without 
overcoming the difficulty. A ten-year old boy or girl, if 
properly instructed, can do all the surgery necessary to 
cure an ingrown toe-nail, and all the instrument needed is 
a common pocket-knife to scrape the edges until they are 
thin, so they can be raised sufficiently to admit a tuft of 
cotton. The scraping should be commenced at least a 
quarter of an inch from the side of the toe-nail, the point 
of the knife being directed toward the flesh, the scraping 
being deeper as the edge is approached. Meanwhile, the 
nails must be trimmed with scissors instead of a knife. 



350 poisons. 

POISONS. 

For the sake of convenience it is best to divide poisons 
into three principal classes, as follows : — 

First. Corrosive poisons, or those that cause death by 
their violent and destructive action upon the stomach. 

This class includes all the powerful acids, both mineral 
and vegetable, and also strong alkaline salts such as caustic 
soda and caustic potash. 

Second. Poisons that act upon the brain and nervous 
system. This class includes morphine, and opium in every 
form, antipyrine and similar painkillers, the most deadly of 
all being prussic acid. 

Third. In this class are included drugs that have a 
tendency to destroy life both by their corrosive action upon 
the stomach and their effects upon the nervous system. 
The well-known drug, carbolic acid, belongs to this class. 

Treatment. — For all poisons that are truly acid, such as 
nitric acid, sulphuric acid, muriatic acid, and strong vinegar, 
common baking soda must be given about as follows : Put 
a heaping tablespoonful of the soda in a pint of water, and 
give a swallow of it every few minutes until gas ceases to 
come from the stomach, and then give three or four table- 
spoonfuls of sweet oil. 

When caustic soda or caustic potash or lye of any kind is 
swallowed, give the following immediately : — 
Vinegar, one ounce, 
Water, three ounces. 

Mix, and give a swallow every few minutes until gas 
ceases to rise from the stomach, then give three tablespoon- 
fuls of sweet oil. 

If morphine, opium, or any other poison, except an acid 



POISONS. 351 

or an alkali, is swallowed, its fatal effects may often be pre- 
vented by giving three or four ounces of sweet oil or sev- 
eral raw eggs. The oil or the eggs get mixed up with the 
poison so its absorption by the stomach is greatly delayed, 
and the effects of the poison being much more gradual in 
coming on are much less dangerous. An immense quan- 
tity of milk or melted butter is also good in such cases. 

The best antidote for morphine after its poisonous effects 
have set in, is the sulphate of strychnine to counteract the 
tendency to profound and fatal slumber, and if the drug is 
given until it causes jerking of the muscles, it will probably 
arouse the action of the brain so as gradually to restore the 
natural action of the heart, lungs, and other organs, and 
save the patient. 

The dose of the strychnine may be from the tenth to the 
fourth of a grain, according to the extent of the poison 
from morphine. It should be given until its characteristic 
effects, which are jerking of the muscles, show themselves. 

The best remedy for strychnine poisoning is morphine, 
and the dose may be a half grain to commence with. 

In addition to this, chloroform should be given by inhala- 
tion until the muscles are perfectly relaxed, and the patient 
should be kept under the influence of chloroform or ether 
sufficiently to prevent spasm of the muscles, until the effects 
of the strychnine have worn away. 

In poisoning from arsenic, several raw eggs should be 
given as soon as possible. The following drug is the best 
antidote : 

Hydrated oxide of iron, in the soft, pulpy form, the dose 
being a tablespoonful as soon as possible and repeated 
every ten minutes until the dangerous symptoms are over. 
The dose for a child is a teaspoonful to a dessert-spoonful, 
according to age. 



352 DISEASES OF THE RECTUM AND ANUS. 



DISEASES OF THE RECTUM AND ANUS. 

In the great list of diseases that afflict civilized mankind 
there is no class of ailments so prevalent; none causing 
more intense suffering ; none that annoys and distresses 
more people in their daily vocations ; and none that causes 
a wider range of sympathetic affections, than diseases of 
the rectum and anus. While there is no part of the body 
more liable to painful and enduring diseases, there is no 
part subject, either through carelessness or ignorance, to 
such shameful neglect and mismanagement. 

It is thought that nearly one-half of the adult population 
in civilized lands suffer more or less from either piles, 
fistula, fissure, or some other form of rectal disease before 
reaching the middle milepost of life's journey, and among 
them are millions whose physical anguish almost makes 
life a burden. 

A careful inspection of Plate I will show the compara- 
tive size, shape, length, and location of the rectum in the 
pelvis. The two muscles, A, A, running back from the 
front bones of the pelvis to the lowest point of the spine 
are called the levator ani, which means lifter of the anus. 

During the act of stooling these two muscles draw up 
the anus and close the neck of the bladder. For this 
reason persons cannot pass their stools and their water at 
the same time. 

When the rectum is distended with feces, the contents 
of the bowels, it occupies a great deal of the pelvis. 
Figure i shows the natural location and curve of the 
rectum, its back surface being very close to the spine, and 




Fig. i, 

A. Complete Fistula. 

B. Blind Internal Fistula. 



353 



354 



DISEASES OF THE RECTUM AND ANUS. 



its curve corresponding mainly with that of the latter, 
while its front surface is almost in contact with the womb. 
The dark line in front of the rectum going upward and 
bending forward to the womb is the vagina. 

In this figure the lower part of the rectum is cut away 
in order to show a complete fistula entering the bowel. It 
is easy to see how distressingly crowded these organs 
become during the early months of pregnancy, when the 
constantly growing womb is wedged in between the rectum 
and bladder. The poor rectum, however, gets the worst of 
it, as it is crowded back against the unyielding spine by 
the heavy and somewhat solid womb, and more or less 
flattened, and in this way serious constipation often occurs. 
The obstruction thus produced offers a resistance to the 
upward passage of the blood through the veins to the 
heart ; causes enlargement of all the veins of the thighs, 
legs, and feet ; and favors the development of piles. At 
length, fortunately, the distended womb becomes too large 
for the pelvis and rises into the abdomen, and as it rises 
out of the pelvis, the rectum and bladder are gradually 
relieved from uncomfortable pressure. 

It is the erect position that throws the weight of the 
bowels and that of their contents more or less upon the 
organs of the pelvis ; it is the erect posture that multiplies 
the afflictions of women during pregnancy ; it is the down- 
ward pressure of the abdominal organs that causes men 
engaged in heavy work to have piles ; it is the weight and 
downward force of the intestines occasioned by our per- 
pendicular position that causes the rectum to protrude so 
many times through the anus ; and it is the upright 
posture that renders both sexes liable to many painful 
affections never found among dumb animals. 




PLATE I.-LEVATORES ANI, SIDE VIEW. 



PROTRUSION OF THE BOWELS. 



355 



This is what it costs in suffering to walk on two feet 
instead of four ; and yet none of us have any desire to be 
a man-monkey, an anthropoid ape, or a chimpanzee; and 
surely none of us would be willing to commence stubbing 
around on our hands and feet in order to escape the pains 
and infirmities of our civilization, distressing as they 
frequently are. 



PROTRUSION OF THE BOWELS. 

Other names : prolapsus ani ; invagination of the rectum. 

This is a derangement in which the rectum, or part of it, 
protrudes through the anus and has to be pushed back 
with the fingers. There are three forms of the disease, 
namely : — 

First. Protrusion in which a part of the mucous mem- 
brane comes down. 

Second. Protrusion in which part of the rectum, includ- 
ing its membranes and muscular coats, comes down ; and 
in this variety the lower part of the rectum is turned inside- 
out like a glove or stocking. 

Third. Protrusion in which the upper part of the rectum 
slips down through the lower part and protrudes several 
inches. This is by far the most serious form and is 
accurately shown in Plate II. 

Causes. — The disease is very frequent in childhood, and 
in almost all cases it is brought on by diarrhoea or dysentery, 
or by the injudicious use of physic. 

Symptoms. — After severe straining at stool, folds of the 
bowel, large or small according to the severity of the case, 
remain on the outside and have to be forced back with the 



356 



PROTRUSION OF THE BOWELS. 



fingers.. In most cases the protrusion involves only a part 
of the membrane or lining of the rectum ; and the bunch 
is not larger than three or four grapes ; but in other and 
severer troubles of this nature, part of the bowel protrudes, 
and the tumor is larger, and harder to work back. 

In still another form, and by far the worst form, too, the 
entire upper part of the rectum falls down through the 
lower part and protrudes two or three inches. 

Sometimes the tumor is of a very different shape from 
that shown in Plate II, and is nearly the form of a pine- 
apple, the large end being down. It is only in chronic 
cases — those that have been years in developing — that 
the folds of the rectum have become so enlarged as to give 
the tumor the form of a pineapple. 

Treatment. — Two very important things are to be done 
in every case of protrusion of the rectum. 

First. The protruding parts must be treated so as to 
reduce as much as possible the irritation and congestion; 
and if this is properly done it will probably prevent further 
protrusions. 

Second. The protruding folds must be pushed back as 
soon as they have been properly treated. 

After the tumor has been cleansed with a soft cloth the 
following should be applied freely : — 

Tannin, two drachms, 
Water, four ounces. 

Mix and apply every time the bowel protrudes. In 
stubborn cases an ounce of the same may be injected three 
times per day. It will not cause much if any smarting, 
but the child will want to pass it of! immediately. 

The following is also very valuable in the treatment of 
protrusions occurring in children : — 





PLATE II: TYPICAL CASE OF PROCIDENTIA RECTI 



PROTRUSION OF THE BOWELS. 357 

Powdered alum, a heaping teaspoonful, 
Water, a half pint 

Mix and apply freely to the protruding parts every time 
they come down. 

As soon as the tumor is treated in this way vaseline 
should be applied in order to make it slip back easily, and 
there is not a doctor in Christendom that can work back 
the wrinkled folds of the bowel any easier than the 
average mother. 

It is not an unusual thing for children with severe 
diarrhoea to have protrusion of the rectum; it is by no 
means serious ; there is nothing to occasion fright or 
anxiety ; but the quicker it is pushed back the better, and 
the less effort it will require to do it While the tumor is 
being worked back the child should be pacified or amused 
in some way, if possible, as struggling and screaming will 
force the parts downward and make the task of pushing 
them back more difficult 

The more the bowel comes down, the more congested, 
thickened, and irritable it is liable to be ; and, consequently, 
the protrusions are apt to become more and more frequent, 
while the protruding folds are equally apt to get a little 
larger; and for these reasons prompt and thorough treat- 
ment is always advisable. 

The cause of the trouble, whatever it is, should be removed 
as soon as possible, as in every other disease. If it is from 
diarrhoea, — and it almost always is, — the treatment advised 
for cholera infantum, p. 44, should be followed until the 
bowels are restored to their healthy and natural condition. 

In almost every case the patient is inclined to linger on 
the seat or vessel and strain a great deal after the stool has 
all been expelled ; and it is usually the straining after 



358 PROTRUSION OF THE BOWELS. 

stooling that forces the rectum, or part of it, out ; and it is 
therefore important to lift the child from the seat as soon 
as the stool has been passed, even if he utters a very loud 
protest, as he usually does. 

Should the case be so bad, on account of neglect or poor 
treatment, that all these measures fail, the next thing is to 
adopt a more radical plan of treatment so as to prevent 
the protrusions entirely. This consists in constructing a 
temporary closet seat for the child, and making it so high 
that the little fellow stands almost straight up while the 
bowels are moving. It may be best to commence with a 
seat that will give a half-erect position, as such a seat will 
be less liable to displease the patient than a higher one ; 
but if it should fail, a higher one must be used, remember- 
ing that the nearer his position approaches the perpen- 
dicular, the less will be the tendency of the bowel to 
protrude; and that the high seat alone will cure almost 
every case, if made so the child will be almost in a standing, 
instead of a sitting position. The writer has used the high- 
seat treatment for twenty-eight years, including seven years 
in the Boston Clinic, and has never known it to fail. 

When the disease exists in adults it is usually from bad 
treatment in childhood, or from piles ; if from the latter, 
they should be cured as soon as possible ; and if the pro- 
trusions continue, the treatment should be the same as for 
children, the seat being so high that the man has to stand 
almost erect. 

There is one particular difficulty attending all cases of 
protrusion of the rectum or its membranes ; one that is 
terribly aggravating ; and it is this : The patients when at 
stool, like a great many ministers when preaching, are not 
willing to quit when they get through. 



PROTRUSION OF THE BOWELS. 



359 



Case I. (Protrusion of the Rectum.) 

Belle D., age 3, became a patient of mine in 1872. The 
protrusions in this case were bad, and included part of the 
rectum in addition to the mucous membrane. 

The treatment for the diarrhoea that brought on the 
trouble was a success, but the protrusions continued for 
weeks, at each movement of the bowels, until the high 
seat was adopted. The position of the child, which was 
almost erect, prevented further protrusions ; complete 
recovery followed within a few weeks ; and there was no 
more use for a two-story seat. 

Case II. (Protrusion of the Rectum.) 

George Parker, age 2 years and 8 months, was brought 
to the Boston Clinic, in 1893, with protrusion of the rectum, 
the entire lower part coming down at every movement of 
the bowels. The case had been under treatment for about 
two months and nothing had yielded much beneficial 
results. I immediately began bathing the protruding 
parts with the following : — 

Tannin, two drachms, 
Water, eight ounces. 

Mix and apply freely to the protruding membranes after 
each movement of the bowels. This was kept up for 
several days and prevented, to some extent, the protru- 
sions, but the child was inclined to sit on the seat and strain 
and strain after he was through stooling ; and his mother, 
notwithstanding my advice to the contrary, permitted him 
to exercise his own sweet (?) will; and in this way the 
treatment partially failed. A high seat was finally made 
so the youngster was compelled to stand almost erect when 
stooling, and in this position his bearing-down effort, though 
long and determined, could not force the bowel out. Com- 



3<5o FISTULA IN ANO. 

plete recovery followed within a few weeks, and the high 
seat was abandoned. 

Case III. (Complete Protrusion of the Rectum.) 
John McConnell, Revere, Mass., age 44, entered the 
Boston Clinic in January, 1893, stating that he had piles 
and falling of the rectum. I here copy from my clinic 
"Record of Cases" the following, word for word: "This 
is the worst case of prolapsus of the rectum that I have 
ever seen. The protruding bowel is as large as an average 
pineapple and somewhat similar in shape. The trouble 
began 12 years ago and has never yielded in the least to 
any treatment." 

In this case there was no apparent cause for the protru- 
sion except the existence of two or three small pile tumors 
of a bluish color. Although it did not seem possible for 
such insignificant tumors to cause the protrusion, I destroyed 
all of them before he left the table, filling each pile sack, 
as I always do, with phevAc-acid solution. I then had a 
closet seat made so high that he was virtually in a standing 
position during the movement of his bowels. The protru- 
sion never occurred once after the use of the high seat was 
commenced ; the cure was permanent, the high seat being 
discontinued after two or three months. 



FISTULA IN ANO. 

In this chapter it is proposed to describe carefully, and 
accurately, yet briefly, the six different forms of fistula that 
are known to exist ; to show their most frequent causes ; 
the manner in which they usually come on ; the best means 
for arresting their formation ; and finally, the surest, easiest, 



FISTULA IN ANO. 361 

quickest, and least painful method for effecting a complete 
and permanent cure. 

The word fistula is purely Latin, and means a pipe. 
Fistula in ano is a pipe, or artificial canal, one end of which 
is usually within an inch of the anus, and called the external 
opening, while the other end is either in the anus or rectum, 
and called the i?itemal opening. It is customary to call all 
fistulous openings occurring in this locality fistula in ano, 
though this is not strictly correct, for a fistula with its 
internal opening above the anus is in the rectum, and is 
properly fistula in recto instead of fistula in ano. 

From the foregoing, it is obviously impossible for a man 
to know what kind of a fistula he has, until an examination 
is made and the internal opening located ; and it may be 
interesting for every one to know that the higher the 
internal opening, the more difficult and tedious the case, 
and therefore, that fistula in recto is more to be deplored 
than fistula in ano. 

Causes. — The direct cause of almost every fistula is an 
abscess in the vicinity of the anus, but as it is often impos- 
sible to know the cause of the abscess, it is equally impos- 
sible to tell the real cause of the fistula. It is very probable, 
that in most cases, the abscess arises from an imprisoned 
clot of blood, known and described as a thrombotic pile 
tumor, as this kind of a clot is really lifeless matter — a 
foreign body in the flesh — and peculiarly liable, sooner 
or later, to cause an inflammatory abscess and, finally, a 
fistula. 

To avoid the danger of a fistula, with all its terrible pain 
and uncleanliness, every thrombotic pile should be destroyed 
as soon as it makes its appearance. Fruit seeds and small 
fragments of bones, swallowed by rapid eaters, who do not 



362 



FISTULA IN ANO. 



properly chew their food, often become lodged in the anus 
or rectum so as to cause an abscess, and in nineteen cases 
out of twenty, whatever causes an abscess in this region, 
also causes a fistula. 

In 1876, Mr. Alexander Adams, of Youngstown, Ohio, 
came to my office, with a bad fistula, from which he had 
suffered for several months, and on account of which, he 
had been attended by the best surgeons of that city. He 
was then in the flower of his age, a very active business 
man, and a rapid eater. After finding that he had a com- 
plete fistula, I inserted a rectal speculum and saw the end 
of a bone projecting, the eighth of an inch above the in- 
flamed flesh. I grasped it firmly with a pair of goose-teeth 
forceps ; carefully worked it loose and extracted it, causing, 
of course, some pain. The bone was a piece of a small 
rib, — probably a lamb's rib, — and was an inch and a quarter 
in length. It was broken almost in two in the middle, and 
was evidently covered with flesh when swallowed, as the 
gentleman remembered having swallowed a piece of meat, 
bone and all, a few months before. 

Having removed the bone, I operated upon the fistula 
with an elastic cord, and complete recovery followed within 
three weeks, the patient attending to his usual duties during 
the treatment. 

There are six kinds of fistula affecting the anus and 
rectum, and about all of them have come under the writer's 
observation, though most of them are exceedingly rare. 
They are as follows : — 

First. Complete fistula, in which there is one external, 
and one internal opening, this form being by far the most 
frequent, and, happily, the easiest to operate upon, and 
also the easiest to cure. 








Fig. 2. 

A. Complete External Fistula, 

B. Recto- Vaginal Fistula. 



363 



364 FISTULA IN ANO. 

Second. Blind, internal fistula, in which there is but 
one opening, and that is within the anus or rectum. This 
form is rare, except when found as the result of an un- 
successful operation upon a complete fistula; and unless 
the passage is carefully explored, by means of a good specu- 
lum, illuminated with an electric lamp, it is liable to be 
overlooked. 

Third. Bliiid, external fistula, in which there is but one 
opening, and that is on the outside. This is probably the 
rarest of all the forms known to specialists, and yet, more 
than half the cases examined by doctors in general practice 
are thought by them to belong to the blind external class, 
simply because they have not had enough experience to 
know how to trace the crooked canal into the rectum. It 
is true that the internal opening may be closed for a few 
days, so as to render the passage of a probe into the 
rectum impossible, but almost all fistulous openings observed 
on the outside connect with the rectum. It was said in 
ancient times that " all roads led to Rome." With almost 
equal truth, it may be said to-day, that all fistulous open- 
ings occurring about the anus lead, either directly or in- 
directly, to the rectum. 

Fourth. Complete, internal fistula, in which there are 
two openings, both being inside. This form is so rare that 
it is seldom seen, even by a specialist 

Fifth. Complete, external fistula, in which there are two 
openings, both being on the outside, and connecting with 
each other but not with the recttim. The writer has suc- 
cessfully operated upon several cases of this kind, although 
they are comparatively rare. 

Sixth. Horseshoe fistula, in which there are several 
openings on the outside, some of which connect with the 



PERSONS MOST LIABLE TO FISTULA. 365 

rectum, and the various pipes circle around the anus, so as 
to give the connected canals the appearance of a horse- 
shoe. Figure 3 represents a horseshoe fistula and shows 
the direction of the pipes, their relation to each other, and 
how they connect with the rectum by a single canal. In 
order to effect a perfect cure in such cases, a great deal of 
time, patience, and skill are necessar«y. 



PERSONS MOST LIABLE TO FISTULA. 

The idea prevails extensively — and a very erroneous 
idea, too — that persons with consumption or a strong 
hereditary tendency to that disease, and also persons 
suffering with scrofula or inherited tendencies to that 
affection, are peculiarly liable to fistula in ano and fistula 
in recto. 

The facts are that any person, however strong and 
vigorous, and however pure and healthful the blood, will 
have a fistula whenever the conditions are such as to 
develop an abscess near the anus; and that fistula furnishes 
no evidence whatever of a primary blood disease; and 
further, that it is no disgrace to be afflicted with a fistula ; 
but it is a burning shame and disgrace to allow it to con- 
tinue, because it is a distressing and loathsome disease at 
best, and in a great measure unfits its victim for the ordi- 
nary duties and responsibilities of life. 

As piles, especially those of a thrombotic type, have 
strong tendencies to the formation of abscesses about the 
anus, it is obvious that persons with piles are peculiarly 
liable to have fistula. 



366 PERSONS MOST LIABLE TO FISTULA. 

A thorough study of fistula with its history and causes, 
and an experience of more than a quarter of a century in 
the treatment of the disease, warrant this broad statement. 
With the exception of those afflicted with piles, one person 
is about as liable to have fistula as another, those suffering 
with piles being, of course, the most liable. All classes 
are equally liable to swallow stones of fruits, or fragments 
of bones covered with flesh, and these may become se- 
creted in the folds of the rectum, causing an inflammatory 
abscess and fistula. 

Symptoms. — The commencing symptoms of a fistula 
are, pain, swelling, great tenderness, and, finally, redness 
of the skin at the central part of the swelling which is 
usually within an inch of the anus and on the right or left 
side. As the swelling increases, the pain becomes more 
and more intense ; there is loss of appetite ; considerable 
fever and now and then a chilly feeling ; a soft, fluctuating 
condition is finally observed about the centre and highest 
part of the swelling, and the fully formed abscess either 
breaks or is lanced, when a copious flow of pus affords 
instant relief. 

For weeks, if not months, there will be an abundant flow 
from the abscess, as the cavity is large, and its pus-secret- 
ing capacity must be equally great. 

As the pond of a creek is wide and extensive during a 
flood, so is the cavity of an abscess when it first opens ; as 
the pond after the flood usually becomes a very small, zig- 
zag channel through a bed of sand, gravel, and clay, so the 
cavity of the abscess, after the flood of pus, is made smaller 
and smaller by the healing process until only a little pipe 
not larger than the lead in my pencil remains, and like the 
channel of the creek, is usually crooked. In forming the 




Fig. 3. 
Showing 5 Fistulas; how they communicate with each other and how one 
enters the rectum. 



367 



368 



PERSONS MOST LIABLE TO FISTULA. 



channel of a creek the water takes the direction in which 
there is least resistance; the pus does the same thing, and 
therefore both stream and fistulous pipe are crooked. 

By the time the cavity of the abscess is filled up and the 
artificial passage reduced to a small pipe, the discharge 
becomes thin and watery, the amount in twenty-four hours 
being small, and yet large enough to soil the linen, irri- 
tate and inflame the skin, and render frequent bathing 
necessary. This is frequently the settled condition of a 
fistula within five or six months after it first makes its 
appearance. 

Sometimes they have a small external opening that will 
not allow a free flow of " matter," and such cases of fistula 
are usually painful much of the time. 

Many of them will close up for days or even weeks, 
causing the patient to flatter himself that he is cured, 
especially so if some foolish doctor has been trying the 
worthless and pernicious plan of injecting caustic solutions 
into the pipe. 

Whenever a fistula closes externally, from whatever 
cause, it should be regarded as a smouldering volcano that 
is liable to make serious trouble at any time, and it is im- 
portant to know that anything causing the pipe to heal on 
the outside has a dangerous tendency to make it open in a 
new place, and as the old pipe usually opens again sooner 
or later, a double fistula is the result 

When the fistulous pipes are large, as they sometimes 
are, offensive gases, and frequently feces also, are dis- 
charged through the opening ; but it is comforting to know 
that this miserable form of the disease is one of the easiest 
to operate upon, and therefore one of the easiest to cure, 
as- a general thing. 



PERSONS MOST LIABLE TO FISTULA. 369 

Other things being equal, a fistula with a pipe somewhat 
large is much less painful than one with a small pipe ; the 
discharge, though a little greater, is more uniform, and the 
fistula is much less liable to close, by healing at one or two 
points, so as to cause the confined matter to force its way 
through sound flesh and make a crooked channel. 

When a wound heals, all the parts involved in the scar 
are hardened ; are more like cartilage or gristle than nat- 
ural flesh, and as pus, in forcing its way out of a cavity, 
always takes the direction in which there is the least resist- 
ance, it works round the scar tissue so as to pass through 
soft flesh, and it is through such unvarying principles that 
a fistulous canal changes its direction every time it heals 
in any part of its course, and breaks out again. 

Every fistula is liable to become more and more crooked 
every year ; every new turn a pipe takes, the difficulties of 
curing the patient by an operation of any kind are in- 
creased, and when it gets very crooked a successful opera- 
tion with the knife is almost impossible. 

Almost every disease is in its most simple and easiest 
form when it first develops ; this is especially true of fis- 
tula in ano and fistula in recto ; and, therefore, no fistulous 
pipe should be allowed to grow old and crooked. 

Another serious change that time and neglect are lia- 
ble to make upon fistula is, an increase in the number 
of openings ; and in order to avoid crooked, distress- 
ing, and numerous pipes, every fistula should be cured as 
soon as possible by destroying the miserable, pus-secreting 
canals. 

By having a fistula properly treated before perplexing 
complications arise, a whole life of suffering from a loath- 
some disease may be prevented. 



370 



PERSONS MOST LIABLE TO FISTULA. 



Treatment. — Seven or eight different methods for oper- 
ating upon fistula in ano and fistula in recto have been 
described by authors ; but as all of these are worthless 
except the elastic cord and the knife operation^ it is not 
proper to describe them here, as it would only confuse the 
reader. There is one style of treatment, however, that has 
been used a great deal by doctors in the general practice ; 
that has done a great deal of harm, and is liable to do 
more; that must be condemned. It is known as the 
" injection method" and consists in filling the pipe with an 
astringent or caustic solution. A great many cases cured 
at the Boston Clinic within the last seven years, had been 
treated for months or years by injections before coming 
to the clinic ; some of them had paid out a great deal of 
money ; none had been benefited in the least ; and half of 
them had been injured by having their fistulous openings 
multiplied. The fluid injected is intended to inflame the 
canal so as to make it heal ; and it often succeeds to the 
extent of causing a great deal of trouble by healing 
the pipe in places ; and in doing this pockets of pus are 
established between the points healed ; the imprisoned pus 
is liable to become the source of several abscesses ; and in 
this way two or three new fistulas may be caused by one 
injection. 

The amount of harm that this pernicious treatment has 
done by partially healing the pipe and causing a number 
of new openings is hard to estimate. Every effort should 
be made to keep the pipe open until it can be destroyed 
in the proper way. There is no palliative treatment that 
amounts to much, and the quicker an operation is performed 
for thorough cure the better. 

The author's favorite method for curing fistula in ano 



PERSONS MOST LIABLE TO FISTULA. 37 1 

and fistula i?i recto, and the one that he has employed 
almost wholly for over a quarter of a century, is to cut the 
fistulous pipe out with an elastic cord ; and his success in 
operating this way has been so favorable that the failures 
in twenty-six years can be counted on the fingers of one 
hand, with fingers to spare. 

The operation is as follows : A soft silver probe having 
an eye in one end large enough to carry the cord, is care- 
fully passed into the fistula until it enters the anus or 
rectum ; then the index finger of the other hand is passed 
into the anus and brought in contact with the end of the 
probe ; as this needle probe is very soft, it is easily bent by 
the tip of the finger and brought out at the anus, drawing 
one end of the elastic out with it, while the other end is left 
hanging out through the external opening of the fistula. 
One end of the cord is then put through a hole in a rubber 
button ; the other end is put through a different hole of 
the same button ; both ends are brought together and tied 
in three hard knots. Within a week the cord makes con- 
siderable progress in cutting its way out through the flesh, 
and in doing so becomes slack; it is tightened up so as 
to cut again, as before, and so on every week until it is 
entirely out. 

The elastic cord consists of a thread of Indian rubber 
covered with silk, and if the patient wishes to attend to 
business while the cord is doing its work, the smallest 
elastic that is made is used instead of a larger one, and 
even if it is tied as tightly as it will bear without the danger 
of breaking, it causes but little if any pain. 

If, however, the patient wants to get through as soon as 
possible, even if the treatment is more severe, a much 
larger and stronger cord may be used, and in that case the 



372 



ADVANTAGES OF THE ELASTIC CORD IN FISTULA. 



work of cutting the fistula out will be accomplished in one- 
third of the time required for the small one, the cure being 
equally thorough in each case. 

As this is a method that never fails when properly used, 
it may be interesting for every one with a fistula to under- 
stand the principles upon which its universal success de- 
pends. 

In the first place a soft probe is always used, one that 
bends or doubles up readily when encountering an obstruc- 
tion, and it is impossible for such a probe to enter the anus 
or rectum without following the fistulous pipe, as it could 
in no way be forced through the sound flesh. For this 
reason the elastic seton comes in direct contact with every 
part of the diseased and pus-secreting pipe, and in doing 
so develops an inflammatory condition that destroys it. 
Its destruction is accompanied and followed by the healing 
process that is kept up until the seton is cut entirely out. 
When the flesh and skin are divided in this way, there 
is no gash or gaping wound left, as one might suppose, 
because the healing follows up the cord so closely that by 
the time it has cut through all the structures the wound is 
about healed up, and the patient is practically well. 



ADVANTAGES OF THE ELASTIC CORD IN 
FISTULA. 

First. It always cures, when properly applied. 

Second. The relation of the different structures to each 
other is not changed in consequence of being divided by 
the cord, because the healing and closing process keeps 
up with the elastic cord in its passage through the flesh. 



ADVANTAGES OF THE ELASTIC CORD IN FISTULA. 



373 



Third. After a person is cured by the cord the parts 
involved are in their natural place, their condition is 
natural, and the feeling of the individual is as natural 
as in childhood. 

Fourth. The application of the cord by an experienced 
rectal surgeon causes but little if any pain, is completed 
within two or three minutes usually, and the use of ether 
is not necessary one time in a hundred. 

Fifth. The elastic-cord treatment is always bloodless, 
is free from danger, doesn't confine a patient to his room, 
allows him to attend to his business as a general thing, and 
the fistula never breaks out again because all the pipe is 
destroyed. 

Sixth. As the healing process caused by the cord 
keeps up until the wound is entirely healed, the patient is 
not left with a fissure of the anus, which is a very painful 
and troublesome ulcer. 

Seventh. The sphincter ani muscles — the muscles that 
close the anus — are not injured by the cord operation, 
although these muscles may be completely severed, and a 
patient will not lose control of his bowels even if a half 
dozen fistulous pipes are destroyed in this way, one at a 
time. 

Eighth. With the cord, there is no blood-blinding opera- 
tion, no fistulous canal to hunt in a sea of blood, no wound 
to sew up, no deformity, no stricture of the anus, no im- 
pairment of the muscles that close the anus, and the sur- 
geon avoids the deplorable, and frequently hopeless, task 
of passing a straight director through a crooked hole, as 
the pipe is almost always crooked. 

Ninth. As the probe used in putting in the cord is soft, 
it will easily bend .so as to adapt its curves to the direction 



374 THE KNIFE OPERATION IN FISTULA. 

of the pipe, and will reach the anus or rectum by following 
the winding road instead of going "across lots," and in this 
way no elbow of the pipe is cut off by forcing the needle 
probe through sound flesh, leaving a part of the pipe with 
a quantity of imprisoned pus to become the source of a 
new fistula. 

Tenth. One of the greatest blessings of the elastic-cord 
method to the world is, that millions who would not submit 
to the knife operation, are anxious to be cured by the cord 
as soon as they learn how quickly and easily it is applied ; 
that the fistula is always cured, and that there is no danger 
and but little if any suffering attending its use. 

For these reasons the first man into whose fertile brain 
the idea of curing fistula with a string gained admission ; 
and who gave the plan to the world — heaven bless his 
name and ashes — is worthy of a higher and grander 
monument than that of Bunker Hill. 



THE KNIFE OPERATION IN FISTULA. 

As previously stated, there are only two methods for 
the cure of fistula in ano waft, fistula in recto that are worth 
considering. One, which has been fully described, consists 
in dividing all the flesh and skin, between the pipe and the 
anus, with an elastic cord ; the other consists in cutting 
through the same structures with the scissors or knife, and 
is known as the knife operation. 

Everything that is uniformly successful in medicine or 
surgery rests upon some fixed and definite principle, or 
principles, and it is interesting to observe that the two 
recognized methods for curing fistula depend upon a single 



THE KNIFE OPERATION IN FISTULA. 375 

principle of vital importance — the division of all the flesh 
lying between the external opening of the fistula and anus. 

The knife operation is the one employed principally in 
all the hospitals ; the one taught in the colleges ; the 
method usually advocated by authors of medical and sur- 
gical works ; but the rectal specialists in the various cities 
almost all prefer the clastic cord, and it is probable that four- 
fifths of the cases that are cured at all, are cured in this 
way. 

Plate III shows the manner in which the knife operation 
is performed. The patient is put under the influence of 
ether, and a silver director, with a groove running its whole 
length, is passed into the outer opening of the pipe ; when 
it reaches the inner opening and enters the rectum, an 
index finger — the one most convenient — is passed into 
the bowel and crooked, so as to catch the end of the direc- 
tor and bring it out at the anus. A suitable knife is then 
placed in the director with its edge turned towards the 
flesh, and pushed along the groove until it cuts through all 
the structures lying above the instrument, including veins, 
arteries, nerves, muscles, and skin. 

The next step consists in spreading the lips of the wound 

apart and scraping out the pipe with a sharp instrument 

called a curette, which is simply a "scraper,'* the term 

curetting being a refined and dignified word for " scrap- 
ie ~ »» 
mg. 

The wound is then packed full of antiseptic cotton, so 
as to keep its sides separated and make it heal only from 
the bottom, and also to prevent blood poison. The manage- 
ment of the case after the operation is of the utmost im- 
portance ; the opening has to be watched and dressed for 
weeks ; the rectum must be washed out with injections of 



3;6 



DISADVANTAGES OF THE KNIFE OPERATION. 



warm water after each movement of the bowels, so as to 
keep the wound clean ; a great deal of watchful care is 
necessary, to prevent the sides from uniting too soon, so 
as to leave an opening at the bottom; the opportunities 
for making mistakes are numerous ; and failures are 
frequent. 

In justice to the knife operation, however, this may be 
said : If such operations were performed only by rectal 
surgeons ; by men of special ability and fondness for such 
work; who have devoted their professional lives to the 
study and treatment of diseases of the rectum ; who are 
skilled in operating and know the importance of all the 
details involved in the after treatment ; failures would be 
comparatively few ; but, unfortunately, this is not the situa- 
tion, as most of the cases in the hospitals are operated 
upon by "omnibus" surgeons — surgeons for everything 
and everybody — who have had but little experience in 
rectal surgery, and therefore are not skilful operators. 
For these reasons, it is by no means strange that persons 
undergoing operations for piles or fistula in the hospitals 
are the most frequent victims of bad practice, often being 
left in a deplorable, if not hopeless condition. 

THE DISADVANTAGES OF THE KNIFE 
OPERATION. 

First. It fails in a multiplicity of cases where the elastic 
cord would succeed. 

Second. It necessitates the use of ether or chloroform, 
which some persons cannot take with safety. 

Third. It is a severe operation at best, and is attended 
with more or less danger. 




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DISADVANTAGES OF THE KNIFE OPERATION. 377 

Fourth. As it is a mathematical impossibility to pass a 
straight director through a very crooked pipe, it is equally 
impossible to cure a fistula having such a pipe by the knife 
op era ti 'on. 

Fifth. The knife cannot be used until a grooved director 
is passed through the pipe into the rectum ; and, as such 
a director is too firm to bend and adapt its curves to the 
direction of the pipe, it is often impossible for it to enter 
the anus or rectum until it is forced through the sound 
flesh ; and in such cases the operation always fails. 

Sixth. With the knife, the structures are all cut through 
at once ; they are hard to keep in their natural relation to 
each other while healing ; and the patient is often left with 
an unnatural feeling and considerable deformity, even if 
the operation is otherwise successful. 

Seventh. The knife operation confines a patient to his 
room for weeks, if not months ; his attendants have to be 
careful and especially skilful ; and the chances for serious 
mistakes in the after treatment are so great that failures 
are frequent, even if the operation is properly performed. 

Eighth. After the grooved director is passed through 
the pipe into the rectum, a butcher can do the cutting as well 
as a surgeon ; it is therefore obvious, that all the skill re- 
quired for either cord or knife operation, consists in following 
the meandering pipe into the anus or rectum ; and it is ten 
times easier to do this with a flexible, snakelike probe, that 
readily turns when the pipe does, than it is to go through 
such a canal with a stiff, unyielding director ; and therefore 
the knife operation is much more difficult than that of the 
cord, and much less effective, as every difficulty that is 
added to any kind of an operation increases the chances 
for failure. 



378 DISADVANTAGES OF THE KNIFE OPERATION. 

Ninth. In the knife operation the muscles that close the 
amis are often injured to such an extent that the patient 
cannot control his bowels, and is therefore compelled to 
wear a napkin as long as he lives. Such a deplorable con- 
dition never follows operations with the elastic cord, even 
if a half dozen fistulous pipes are destroyed, because the 
structures unite almost as fast as they are cut, the muscles 
being left in a natural and perfect condition. 

Tenth. The after treatment in the knife operation is a 
source of anxious care for weeks, if not months, and some- 
times the wound will not heal at all ; while there is no after 
treatment necessary when the elastic cord is used except to 
tighten it up once per week ; there are no chances for a 
failure ; the patient avoids the expenses of a hospital ; has 
no use for a nurse ; can attend to his business as a general 
thing ; the structures unite almost as rapidly as they are 
cut through ; their relation to each other is unchanged ; and 
the cure is perfect. 

Eleventh. One of the greatest objections to the use 
of the knife in curing fistula is this : It is regarded as a 
bloody, a dangerous, and a dreadfid operation by the people ; 
they are constantly hearing of failures or deaths from 
such operations in the hospitals; there is not one in a 
hundred that will endure it; and the worst of it all is, they 
have become frightened ; are distrustful of all methods for 
curing the disease ; and ninety-five per cent of those with 
fistula are jogging down life's road with their loathsome 
afflictions, unaware that the elastic suing is an easy, 
simple, safe, sure, and bloodless remedy for fistula in ano 
and fistula in recto. 

Case IV. (Fistula in Ano.) 

A. W. Fulton, merchant, Walpole, Mass., age 38, entered 



DISADVANTAGES OF THE KNIFE OPERATION. 379 

the Boston Clinic in January, 1893, with a fistula of the 
anus from which he had suffered for years. He stated 
that it did not go into the rectum, that the pipe had been 
examined and probed by several distinguished surgeons, 
and all of them said it did not enter the rectum. It took 
me but two or three minutes to trace the pipe into the 
rectum, and as soon as this was done I put in an elastic 
cord ; secured it by three hard knots ; and he returned to his 
duties in his boot and shoe business. The cord soon cut 
its way out, the flesh healing behind it, so by the time it was 
out the fistula was practically well. Mr. Fulton attended 
to his store every day and was sound and well within a month. 

Case V. (Fistula in Ano.) 

Mr. Newton M., a retired business man, age 63, came 
to the Boston Clinic, May 29, 1893, stating that he had 
been suffering from a serious bladder trouble for a number 
of years; that he had been examined by several distin- 
guished surgeons, and that they had all failed to discover 
the cause of his trouble. He had a constant desire to 
pass his water ; could not walk three blocks without want- 
ing to find a water closet; and had to get out of bed a 
dozen times every night. As he never had had an abscess ; 
and as no doctor had ever been able to find any trouble 
with his rectum, it seemed scarcely worth while to hunt 
for a fistula, and yet I looked for one and I found it. I 
put in an elastic cord, secured it with three hard knots; 
it cut out in ten or twelve days ; the cure was quick and 
perfect, and the bladder trouble, strange as it may seem, 
ceased forever. There were many strange things con- 
nected with this case. 

First. The water trouble had existed for years and no 
one had been able to find its cause. 



38o 



DISADVANTAGES OF THE KNIFE OPERATION. 



Second. The fistula was an inch from the anus and on 
the opposite side from the bladder. 

Third. There was no discharge of matter from the 
pipe; no red point indicating its opening; it seemed 
nothing but a small, dry hole in the skin ; and there never 
had been an abscess. 

Fourth. The introduction of the cord relieved the 
bladder irritation immediately, and it never returned. 

Case VI. (Fistula in Ano.) 

Charles L. Foss, electrician, Claremont, New Hampshire, 
age 45, entered the Boston Clinic in 1893, with a fistula 
that had caused him much trouble and anxiety. As his 
business would only permit him to remain in the city a 
short time, he wanted to be cured as soon as possible. 
For this reason I put in the largest and strongest elastic 
cord I had ; it cut out within five days ; he returned home 
on the day it came out, and he was well within two weeks. 
He travelled about the city and had a good time every day 
while the cord was doing its work. 

Case VII. (Fistula in Recto.) 

Benjamin F. O'Connor, 22 Morris St., Lynn, Mass., 
came to the Boston Clinic in 1894, with a terribly bad 
fistula in recto. He had suffered for several years, and 
had been punished a great deal by a doctor who had been 
trying to cure him by the injection method. The case was 
one of the most difficult, as the probe, when introduced 
into the pipe, entered the rectum so high that it was hard 
to reach the point with the index finger and bring it out at 
the anus, but I succeeded in getting it out, and put in a 
strong elastic cord. It took it six weeks to cut out, but 
the healing process followed the cord so closely in its 
passage through the flesh that the patient was practically 



DISADVANTAGES OF THE KNIFE OPERATION. 381 

well when the cutting was done. Mr. O'Connor worked 
at his trade most of the time while being cured. 

Case VIII. (Horseshoe Fistula.) 

Mr. V. D., a fruit dealer, age 40, entered the Boston 
Clinic in 1894, with five fistulas, a form of the disease 
termed a "horseshoe fistula." He had undergone the 
knife operation three times at one of the leading hospitals 
of the city, and every one of them failed. I operated on 
all the fistulas, one at a time, the case being quite similar 
to the one shown in Fig. 3. 

Every fistula was cut out with the elastic cord ; the 
healing was perfect; not one of the operations failed; he 
attended to his fruit store during the six months he was 
under treatment; and is now entirely well. I saw a very 
similar case in a London hospital in 1894 — a case in 
which the knife operations had also failed. 

Case IX. (Double Fistula.) 

J. I. Nickerson, house builder, 592 Sixth St., South 
Boston, age 56, entered the Boston Clinic in June, 1897, 
with a double fistula that had been making his life misera- 
ble for several years. One was treated immediately with 
the elastic cord ; it cut out within two or three weeks ; it 
healed almost as fast as it cut out ; and the second fistula 
was operated upon in the same way. Both healed promptly, 
and he was entirely well within six weeks. He worked at 
his trade while being cured. 

Case X. (Fistula in Ano.) 

W. F. Sinclair, South Gardner, Mass., arrived at the 
Boston Clinic in January, 1898, and was suffering with a 
painful fistula. It only required two or three minutes to 
pass the soft probe into the rectum and put in the elastic 
cord, the operation being almost painless. He came back 



382 



DISADVANTAGES OF THE KNIFE OPERATION. 



to the clinic twice to have the cord tightened ; it soon cut 
out; and he was well within three weeks. 

Case XL (Fistula in Recto. A terrible case.) 

C. P. Stone, 45 Walton St., Fitchburg, Mass., age 52, 
came to the Boston Clinic in December 1898, with a very 
bad fistula in recto, from which he had suffered for twenty- 
six years. He stated, that about 1872 he underwent an 
operation for the fistula ; that it soon broke out again ; and 
had pained and annoyed him ever since. The pipe was 
desperately crooked ; was very hard to follow ; and entered 
the rectum so high that it was exceedingly difficult to reach 
the probe with the end of the front finger and bend it 
downward, so as to bring it out at the anus, but I finally 
succeeded, and in this way put an elastic cord through the 
long and crooked pipe. The previous operation, as un- 
successful knife operations always do, made this case tedi- 
ous and difficult, because the scar tissue, resulting from the 
cutting done in 1872, was so hard, that it took ten weeks 
for the cord to pass through it. Every fibre of the external 
and internal muscles of the anus was divided by the cord, 
and if it had been done with a knife, a man's fist could 
have been passed into the rectum, but as the healing 
almost kept up with the cutting, his power to control the 
bowels was not impaired. Mr. Stone is now well. 

Case XII. (Fistula in Ano.) 

John D. Turner, a commercial traveller, 350 Tremont St., 
Boston, entered the Boston Clinic in 1895, with a very dis- 
tressing fistula, from which he had suffered for a long time. 
It took only two or three minutes to pass a probe through 
the pipe into the rectum, and put in the elastic cord and 
tie it. It cut out in about two weeks, Mr. Turner attend- 
ing to his usual business in the meantime. By the time 



RECTO-VAGINAL FISTULA. 



333 



the cord came out the healing was almost done, and he 
was well within three weeks from the time he first entered 
the clinic. 

RECTO-VAGINAL FISTULA. 

In this form of fistula there is an opening between the 
vagina and rectum. The opening may be merely in the 
edge of the vagina, and may also be in the edge of 
the anus, and yet, where the two passages are connected 
by a fistulous pipe, it is always called recto-vaginal fistula. 

Causes. — In almost all cases the disease is caused by an 
abscess ; but instead of its breaking or being lanced on the 
outside, it either breaks in the vagina or has to be lanced 
within that cavity. 

Symptoms. — It commences as a swelling, between the 
anus and vagina; is characterized by pain and tender- 
ness, both gradually increasing ; fever, redness of the skin, 
and all the symptoms of an abscess, until a copious flow of 
pus and complete relief from pain announce that an open- 
ing has occurred within the vaginal walls. On the other 
hand, the pain may be so great as to render lancing neces- 
sary. Either one of the three following symptoms will 
afford almost positive evidence of a recto-vaginal fistula : 

First. The presence of fecal matter in the vagina, as 
such matter is sure to reach that passage if the opening 
connecting it with the rectum is large. 

Second. The escape of gases having a fecal odor from 
the vagina. 

Third. A constant but moderate discharge of pus from 
the vagina, irritating that passage and inflaming the adja- 
cent skin more or less. 



384 



RECTO-VAGINAL FISTULA. 



Treatment. — The best possible method of cure is to cut 
through all the structures lying between the opening within 
the vagina and the anus, always using the elastic cord as 
advised in all other operations for fistula. The author has 
often found it necessary to cut through almost the entire 
perineum or bridge between anus and vagina, but if the 
cord is not made very tight, the cutting will be so slow 
that the healing will keep up with the cord, and there will 
be little, if any wound, after the structures are all divided. 
There is one form of recto-vaginal fistula in which it will 
not do to divide the flesh and muscles between the two 
passages either with the elastic cord or with the knife. In 
such cases there is a mere window, as it were, between the 
front passage and the rectum ; the opening is often caused 
by the difficulties of childbirth, especially from the use of 
instruments. 

Case XIII. (Recto-Vaginal Fistula.) 

Miss Annie E. Thompson, 36 First St., Lowell, Mass., 
age 34, applied for treatment at the Boston Clinic, May 5, 
1897. She had undergone the knife operation seven years 
before, the fistula breaking out again within a month or 
two. An examination showed that the fistula opened in 
the rectum, above all the muscles of the anus, and that 
almost all the structures between the vagina and anus 
would have to be divided. 

The elastic cord was put in without much difficulty and 
the case treated exactly as if it had been fistula in ano. 
All of the sphincter ani muscles — the ones that close the 
anus — were severed by the cord, but they united so com- 
pletely that there was no loss of power to control the 
rectum. She was entirely well within a few months and 
has been dry and natural ever since. 



FISSURE OF THE ANUS. 385 

Case XIV. (Recto-Vaginal Fistula.) 

Mrs. F , Concord, N. H., age 41, applied for treat- 
ment at the Boston Clinic, December, 1897, and was suffer- 
ing from three fistulas, one of them opening into the vagina. 
I operated upon all three of them — one at a time — with 
the elastic cord, leaving the recto-vaginal operation till the 
last. Each operation was entirely successful, the recto- 
vaginal fistula causing no extra trouble. 



FISSURE OF THE ANUS. 

Other names : painful ulcer of the anus ; anal fissure ; 
rectal ulcer. 

The word fissure means a cleft, crevice, rent, or crack ; 
and a fissure of the anus is a crack in the skin, or mucous 
membrane, or in both ; and is usually about where the skin 
and mucous membrane unite with each other, the lower and 
outer part being in the skin ; and the upper and inner part 
in the membrane. 

Causes. — It is very probable that ninety-nine out of one 
hundred cases of fissure are caused by constipation in 
which the stools are large, dry, and hard. Such a stool is 
liable to tear the skin and mucous membrane in several 
places at the same time and cause a number of fissures 
similar to those shown in Plate IV. 

Symptoms. — The most prominent symptom is pain, which 
is usually severe and out of all proportion to the size and 
appearance of the fissu?-e; and the time at which the dis- 
tress occurs, affords the patient the greatest evidence of 
the nature of his affliction. It commences during the act 
of passing the stool ; may continue for a half hour, or a 



386 



FISSURE OF THE ANUS. 



half day after the movement of the bowels; there is fre- 
quently intense agony, confining the patient to his room or 
bed ; and the suffering is greatly aggravated and prolonged 
by large, hard, and dry stools. 

Treatment. — If it were possible to cure a fissure caused 
by constipation, attended with very large and firm stools, 
it could do but little, if any good, as such stools would tear 
the skin and membranes again and cause new fissures. 
When the patient adopts the treatment advised in the 
chapter " How to Prevent Piles, Fistula, and Fissures," 
and follows it for a month or two, so as to cure himself of 
constipation, his fissure can also be cured, and the cure 
will be permanent. 

The palliative treatment of the disease is of great impor- 
tance in reducing or preventing the suffering ; and if the 
patient will follow the advice given in the chapter already 
referred to, the constipation will cease; the bowels will 
move every day without physic or injections; the stools 
will be soft and moist instead of dry and hard ; pain will 
be reduced greatly in severity and duration ; and most of 
the fissures, like those shown in Plate IV., will get well 
without any operative measures whatever. In commenc- 
ing the palliative treatment of these painful ulcers of the 
amis and rectum, there is nothing so important as the avoid- 
ance of a hard stool, and, for this reason, the patient 
should take a free injection of warm water before each 
movement of the bowels, until the proper treatment of 
constipation renders such injections unnecessary. 

When a patient realizes that eating meat causes consti- 
pation ; constipation causes hard stools ; hard stools cause 
fissures ; and fissures cause enough pain and physical 
anguish to destroy all the happiness and prospects of life ; 




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FISSURE OF THE ANUS. 387 

he is surely prepared to give up forever the pleasures of a 

meat diet. To hasten the healing process and close the 

numerous cracks that are often found in the skin and 

membranes of the amis, the following is of great service : — 

Zinc ointment, two ounces, 

Venice turpentine, three drachms, 

Carbolic acid, one drachm. 

Mix, and apply it with the front finger every night and 
morning. 

There are four operative methods in general use for the 
cure of fissure of the anus. 

First. Cauterizing it with a drug or red-hot iron. 

Second. Stretching the muscles of the anus with the 
thumbs, as shown in Fig. 4, the patient being under the 
influence of ether or chloroform. 

Third. Cutting through the floor of the fissure from 
one end to another with a knife. 

Fourth. Making a cut the shape of a V the entire 
length of the fissure so as to remove a V-shaped piece 
of flesh including it. This is certainly a very radical 
measure, as the fissure is cut entirely out and thrown in 
the ash barrel. 

All of these methods are more or less successful, but 
the last three are very severe, and the cases that cannot 
be cured by milder and equally effective means are exceed- 
ingly rare. 

In the author's early experience with diseases of the 
rectum he used the knife a great deal, but finally found it 
was unnecessary. 

The method that he has employed for seven years at 
the Boston Clinic is this : — 

First. Remove the cause by curing the constipation. 



388 FISSURE OF THE ANUS. 

Second. Make the fissure perfectly clean from end to 
end by wiping it out with a tuft of cotton held by a pair of 
forceps, being very careful not to make it bleed. 

Third. Burn every part of it with the melted crystals 
of phenic acid, which is a painless caustic. It is painless 
because it destroys the sensation of the part touched for 
five or six hours. 

When this acid is applied the entire floor and edges of 
the fissures are turned white ; it takes on a healthy action 
and commences to heal, the lower and outside part heal- 
ing first. One thorough application of the phenic acid is 
frequently sufficient to cure a case, but occasionally it has 
to be used three or four times. 

After the constipation has been entirely overcome so as 
to insure soft and easy stools, it is moonlight rambles to 
cure the fissures with phenic acid, and the writer has never 
had a case in the Boston Clinic that he could not cure in 
this way. 

Case XV. (Fissure of the Anus.) 

Charles F. Tenney, East Mapleton, Mass., age 50, came 
to the Boston Clinic in November, 1894, and was suffering 
from a painful fissure of the anus. I cleaned the ulcer 
thoroughly with a tuft of cotton so as to remove every 
drop of pus and mucus and leave it clean and dry, then 
turned it as white as milk with the melted crystals of 
phenic acid. The operation was repeated in one week, 
the application of the drug causing no pain, and the fissure 
was entirely healed and well within fourteen days. 

Comment. — In all cases operated upon with the phenic 
acid or any other caustic, it is of the utmost importance 
to have every part of the ulcer thoroughly clean, as the 
presence of pus, mucus, or any foreign matter is liable to 




Fig. 4. 
Showing the Hospital Operations for Stretching and Enlarging the Anus in order 
to cure a Fissure. 



389 



390 



FISSURE OF THE ANUS. 



prevent the full action of the caustic. Should cleansing 
the ulcer start it to bleeding, it is useless to apply the 
caustic until the blood has ceased to flow and the ulcer 
has become perfectly dry. A failure to understand the 
importance of these little things, as they seem, has caused 
numerous failures in the caustic operations and afforded 
excuses for the terribly severe methods employed in most 
of the hospitals. 

Case XVI. (Painful Fissure of the Anus.) 

Dr. Cutler, 532 Tremont St., Boston, escorted a beauti- 
ful young lady, Miss M., to the Boston Clinic in 1898, 
stating that she had a very painful fissure of the anus and 
had been advised to take ether and undergo the stretching 
operation at the hospital — an operation similar, to the one 
shown in Fig. 4. 

Of course I told her that such severe operative measures 
were unnecessary ; that she could be cured much easier 
and quicker in another way; that she would not need 
ether; and would neither be confined to her bed nor room. 
The fissure was nearly an inch long ; the lower and outer 
half being in the skin, and the upper and inner half in the 
mucous membrane. 

Every part of it was wiped out with a tuft of cotton until 
it was clean and dry ; then it was cauterized with the 
melted crystals of phenic acid until it was white ; a little 
vaseline was rubbed over it to protect the adjacent parts; 
and she was told to return in one week. At her second 
visit to the clinic the lower and outer part of the fissure 
was entirely healed, while the healing process had com- 
menced in the upper part. I applied the phenic acid 
again, and in another week she was entirely well. The 
operations were painless. 



PILES. 39! 



PILES. 



Another name : hemorrhoids. 

The medical term for this exceedingly common and dis- 
tressing disease, is hemorrhoids, a Greek word meaning a 
slow hemorrhage or bleeding. 

Piles are small tumors varying in number from one or 
two to a half dozen or more situated in the lower part 
of the rectum, and consist of a network of enlarged and 
multiplied blood-vessels, covered by the mucous membrane 
of the rectum. 

This membrane, in connection with the skin and other 
parts, forms a sack that encloses the numerous veins, 
arteries, and smaller vessels of which a pile tumor is 
composed, such a tumor being of a soft, pulpy nature, and 
full of blood. 

Causes. — The predisposing causes of piles are : — 

First. Man's erect position that favors, through gravity, 
the downward pressure of the bowels upon the pelvis and 
its organs so as to retard, more or less, the upward flow 
of blood through the veins to the heart. 

Second. The absence of valves in the hemorrhoidal or 
pile veins, so as to prevent the blood on its way up the 
body to the heart from running back. 

Third. Heredity. 

The predisposing causes of piles we cannot possibly 
avoid nor mitigate. We cannot walk, as the inferior 
animals do, with our bodies in a horizontal position; we 
cannot supply our defective blood-vessels with valves ; and 



3Q2 TILES. 

we cannot get rid of our inherited tendencies to the 
disease, if we have any. 

There is scarcely anything in connection with this sub- 
ject more important than a careful study of the exciting 
causes of piles, as they can usually be avoided or greatly 
modified. 

The exciting causes of the affection may be stated 
briefly as follows : Pregnancy ; atonic dyspepsia ; defective 
circulation of the blood through the liver; constipation; 
severe purging, or what is quite as bad, the deplorable 
habit of taking physic for constipation ; sedentary habits, 
giving rise to indigestion, derangement of the liver, and 
intestinal torpor ; over-eating ; the intemperate use of 
alcoholic liquors ; irregular habits ; neglect to allow the 
bowels to move at the proper time ; heavy work or lifting 
in which the bowels are crowded downward ; and last but 
not least, over-work, mentally, through which so much 
nerve force is consumed that there is not enough left to 
stimulate sufficiently the many organs of the body, in 
consequence of which they fail more or less in the per- 
formance of their different functions. Some writers claim 
that piles are almost as common among women as among 
men. This does not seem to be true, as the author, in 
counting a thousand cases of piles as they appeared in 
their regular order in his case-books, found seven hundred 
and twenty of them were men, and two hundred and 
eighty were women. His experience in Ohio and western 
Pennsylvania where he operated upon an immense number 
of cases in the seventies was about the same as in the 
Boston Clinic, showing that but little more than one-fourth 
of all persons applying for treatment were females. 

The disease rarely occurs, if at all, during childhood, 



EXTERNAL PILES. 



393 



and persons under twenty years old with fully developed 
piles are so rare that even a specialist will see but few 
cases in a lifetime. 

It has been the custom of writers for ages to divide 
piles into two general classes, external and internal. 



EXTERNAL PILES. 

These are small tumors situated near the anus, and are 
of two varieties, namely : — 

i. Thrombotic. 2. Cutaneous. 

Thrombotic Piles. 

This form consists of small, bluish tumors, usually 
round or oval, near the anus; are always covered with 
skin ; never go into the rectum, and each one consists of 
a clot of blood beneath the skin. The clot has a hard, 
firm feeling like a bullet ; it may be very near the surface, 
or more deeply seated; may be tender and painful, or 
almost entirely free from pain and tenderness. 

Causes. — As thrombotic piles consist of blood clots, 
they are always the result of a hemorrhage in the tissues 
beneath the skin. 

Plate V shows almost the exact appearance of a throm- 
botic pile. 

Symptoms. — Hard lumps, ranging in size from a small 
bullet to that of a cherry, make their appearance suddenly 
near the anus, and are usually due to severe straining at stool 
during which blood-vessels are ruptured and hemorrhage 
occurs beneath the skin. As blood soon fills the limited 



394 



EXTERNAL PILES. 



space to which it is confined, it presses firmly upon the 
mouth of the ruptured vessel and stops the bleeding ; the 
clot, however, cannot get out, and a permanent thrombotic 
tumor is the result. Tumors of this kind are especially 
liable to take on an inflammatory action and develop an 
abscess ; and as whatever causes an abscess near the anus 
almost always causes fistula in ano, or fistula in recto, the 
importance of getting rid of thrombotic piles as soon as 
possible is very obvious. 

Treatment. — This is easy and painless, and always 
successful. An assistant directs a spray of chloride of 
ethyl upon the tumor for five or six seconds; it turns 
white, the hoar-frost spreading all over it ; a small knife 
with a double edge is then passed through it in its longest 
direction, the cutting being painless ; the round and firm 
clot bursts out quickly as a general thing, but if it does 
not it is scooped out with a small, spoonlike instrument 
called a curette; and that is really the end of the trouble, 
as the wound heals within a few days. There is no bleed- 
ing, and no after treatment is necessary, as the writer has 
rarely known another clot to form in the sack after it has 
been opened in this way. 

Case XVII. (Thrombotic Piles.) 

Mrs. Emma Smith, Waltham, Mass., a lady whose 
general health was good, called at the Boston Clinic in 
November, 1896, stating that she had protruding piles. 
She was having considerable pain, and was in mortal dread 
of some terrible surgical operation. She was placed upon 
the table on her left side with her face to the wall, and 
two large thrombotic tumors were found near the anus. 

She was frightened at the suggestion of a knife opera- 
tion, as people usually are, but when assured that it would 













PLATE V.- THROMBOTIC .PILES 



EXTERNAL PILES. 395 

be painless and almost bloodless, she decided to have the 
tumors removed. A spray of the chloride of ethyl was 
turned upon the largest one for a few seconds ; it turned 
white ; a double-edged knife was passed through it ; the 
clot popped out instantly ; was placed upon a sheet of 
white paper and shown to the patient, who laughed, and 
said the operation was simply fun. The other one was 
removed in the same way; the relief from suffering was 
instantaneous ; and the openings healed within two or 
three days. 

Case XVIII. (Thrombotic Piles.) 

Senator F , of Maine, arrived at the Boston Clinic 

in November, 1897, and was suffering with three throm- 
botic pile tumors, one of them being very large. Their 
cause and nature were fully explained to him ; he was told 
that they were not really piles; but were clots of blood 
under the skin ; that their removal would be painless ; the 
bleeding would be limited to a few drops ; and the cure 
would be perfect. A spray of the chloride of ethyl was 
played upon the largest one ; it turned white in a few 
seconds ; was opened in its longest direction with a double- 
edged knife ; the clot, as large as a small cherry, was lifted 
out with a curette, the operation from first to last being 
painless. The others were removed in the same way 
before he left the table, and he went home within a few 
days perfectly well. 

Case XIX. (Thrombotic Piles.) 

A. W. Fulton, merchant, Walpole, Mass., who had been 
cured of a bad fistula in ano five years before at the Boston 
Clinic, applied to be examined again in the fall of 1897, 
stating that he feared he had another fistula. An examina- 
tion revealed a large thrombotic pile tumor that was tender 



39^ 



EXTERNAL PILES. 



and somewhat inflamed. A spray of the chloride of ethyl 
was directed upon it for a few seconds ; it turned white ; 
was opened freely with the double-edged knife ; and the 
clot was scooped out. He laughed over the painless opera- 
tion and was well in forty-eight hours. It is more than 
probable that his fistula, causing him years of suffering, 
started from a thrombotic pile very similar to this one. 



Cutaneous Piles. 

These are not piles at all, but are merely enlarged and 
multiplied folds of skin at the edge of the anus. To put 
the name in the plainest English, they are skin-piles. As 
a general thing they are not painful nor even tender, but 
sometimes they become so. They are always a source of 
uncleanliness, and, for this reason, if no other, are a con- 
stant annoyance, and should be removed. 

Causes. — They are generally caused by severe constipa- 
tion and frequent attacks of piles. 

Treatment. — It is best to avoid removing these skin-tumors 
when they are inflamed and swollen, as it is hard, when they 
are in such condition, to tell how much of each one should 
be taken off. The way in which the writer removes these 
so-called tumors at the Boston Clinic is as follows : An 
assistant directs a spray of ethyl chloride upon the one to 
be removed ; it turns white with frost in from five to ten 
seconds ; as soon as every part of it is whitened in this 
way, the curved scissors are closed upon it, cutting it off. 
The scissors are not felt ; it only bleeds a few drops ; no 
after treatment is necessary; and the small wound soon heals. 
In order to avoid any smarting from the chloride of ethyl 




PLATEVL-SHOWING THE PATHOLOGY OF INTERNAL HEMORRHOIDS 

A. Superior Hemorrhoidal Veins. 

B. Middle 

C. Inferior 

D. Hemorrhoidal Plexus by removal of tlie Mucous Membrane. 

E. Protruding Internal Hemorrhoids covered by the Mucous Mem brana. 



URK S McFETBIDCE CD LITE PHIL A 



INTERNAL PILES. 397 

as it melts, the wound, in all cases, should be covered with 
carbolized vaseline as soon as possible after the cutting 
is done, as this protects it from the drug, and is also a 
valuable antiseptic. 



INTERNAL PILES. 

These are a hundred fold more serious and distressing 
than the external variety. They consist of a network of 
enlarged and multiplied blood-vessels; are covered by 
mucous membrane instead of skin ; are of a red, or bluish- 
red color ; and from the time they first appear until they 
are destroyed by the proper treatment, or until the patient 
dies, from some cause, they generally maintain a steady 
growth. Plate VI affords a beautiful view of the anus and 
lower part of the rectum. In this drawing the muscles 
that close the anus are cut through ; the rectum is opened 
for a few inches; part of its mucous membrane is cut 
away ; and the pile veins are uncovered. The dark part 
at the lower border of the drawing represents the " pile- 
bearing inch," or inch and a half, and piles are never found 
above its upper margin. When the anus is closed the 
numerous pile tumors observed in the pil'e-bearing inch and 
a half are crowded together ; they completely fill the pas- 
sage ; and there is no chance for the stool to escape until 
they are all forced outside and become protruding piles. 

Symptoms. — In the majority of cases, the first symptom 
of piles observed by the patient, is bleeding from the 
bowels when he is at stool. This may occur occasionally, 
for two or three years, the bleeding gradually becoming 
more frequent and profuse: at first the piles are small; 



398 



INTERNAL PILES. 



protrude but little ; and return without being pressed back 
by the hand ; but as time goes on they become larger, 
their growth being regular, like that of a young animal; 
and finally they get so large, they have to be forced back 
with the fingers, after each movement of the bowels ; they 
still continue to enlarge ; bleeding may be more and more 
profuse ; heavy, agonizing pains are liable to be frequent ; 
there is often a burning sensation in the anus ; the patient 
may be so pale, weak, and emaciated from loss of blood, 
as to be a complete invalid ; and meanwhile the piles get 
larger and larger, with greater and greater tendencies to 
protrude, until they come down a dozen, or even twenty 
times per day. 

Plate VII shows the exact appearance of an average 
case of protruding and bleeding piles. It is important for 
every one to know that internal piles, when once fairly 
started, have a regular growth, like a tree or plant ; and 
that the increase in size and number of blood-vessels of a 
pile tumor is in direct proportion to its enlargement ; that 
the bleeding increases in severity and frequency with the 
increasing age of the piles and patient ; and that internal 
piles, as a rule, never get their full growth, but keep get- 
ting larger and larger as long as a person lives. The 
experience of almost every one who has had piles for 
thirty, forty, fifty, or sixty years, is about the same as that 
of the German who said : " So much older I gets, so much 
bigger grows, by Jesus Christ, my piles." 

Treatment. — The palliative treatment, so far as salves 
and ointments are concerned, amounts to but little ; but as 
piles are caused mainly by constipation or the abuse of 
physic, it is evident that any changed conditions in the life 
and habits of the patient that will cause regular, easy, and 















Xg, 



PLATE VII. -PROTRUDED HEMORRHOIDS WITH PROLAPSED 
MUCOUS MEMBRANE. 



INTERNAL PILES. 



399 



natural movements of the bowels will have a strong ten- 
dency to retard the growth of the pile tumors. The pallia- 
tive treatment, therefore, is entirely hygienic, and consists 
in the absolute avoidance of physic ; leaving off meats of 
every kind ; living upon fruits and vegetables ; and always, 
except when the stools are soft and the bowels move easily, 
using injections of warm water before going to the closet. 
For further information the reader is referred to the chap- 
ter " How to Prevent Piles, Fistula, and Fissure," and 
assured that the advice therein given, if carefully followed, 
will not only prevent those diseases, but will cure a great 
many cases of piles. 

There is scarcely anything easier and quicker than the 
total destruction and permanent cure of piles ; and to re- 
move them with the knife, the clamp, and scissors, or 
with the ligature, is as cruel as it is unnecessary; and 
is like using a sledge-hammer to drive a tack. 

The modern treatment for destroying protruding piles; 
bleeding piles that never show themselves on the outside ; 
and every form of the disease that can be called a pile 
tumor, is the one discovered by the author away back in 
the seventies, and has been used by him in thousands of 
cases. It consists in touching the pile structure with a 
drug that renders it insensible for a few minutes ; then 
piercing it with a hypodermic needle, that is painless ; and 
injecting it, from bottom to top, with a solution that causes 
no pain, and yet is strong enough to destroy the blood- 
vessels of the tumor. 

As soon as a pile is treated in this way it begins to 
perish, as the supply of blood necessary to its life and 
growth is cut off. By the second day it has a dark, 
mottled appearance; by the fourth it is black; and by 



400 



INTERNAL PILES. 



the seventh or eighth day it has fallen off and disappeared 
forever. 

It is the total destruction of the entire pile sack, with all 
its enlarged and manifold blood-vessels, that makes the 
injection method, if properly used, absolutely perfect; and 
nothing can be said truer than this : // is the 07ily treat- 
ment or operation that will destroy every part of a pile tumor 
without including some of the adjacent parts ; it is the only 
bloodless and painless method ; the only one that will permit 
patients to work or atte?id to business while being cured ; it 
is the only kind of treatment that is always successful ; the 
only kind that neither requires ether nor chloroform ; and 
the only kind that is always free from danger. The hypo- 
dermic syringe is now used in ninety-five per cent of all 
the cases that are cured; the length of time required to 
effect a perfect cure is from one to three weeks ; and the 
patients only have to be treated once per week. 

Plate VIII shows most beautifully and accurately the 
kind of operations that are performed in almost all the 
hospitals; and the kind that are still taught and advised 
in most of the medical colleges ; but, fortunately for man- 
kind, most of the rectal specialists have entirely abandoned 
such torturing and dangerous methods. The facts favor- 
ing the universal employment of the hypodermic syringe 
instead of the clamp, scissors, and cautery, as shown in the 
plate, are as follows : — 

First. The treatment with the hypodermic is almost, if 
not entirely painless. 

Second. Neither ether nor chloroform is ever required. 

Third. Patients are neither confined to bed nor room 
during treatment, but can work or attend to their usual 
business affairs. 




PLATE VIII -CLAMP ADJUSTED AND SCISSORS 
IN POSITION FOR EXCISION OF HEMORRHOIDS. 



INTERNAL PILES. 401 

Fourth. The injection method never fails when properly 
used, as an experienced surgeon always fills the entire pile 
sack with the solution, and the whole of the diseased struc- 
ture is therefore destroyed. 

Fifth. While it destroys every part of a pile tumor, it 
never injures the adjacent flesh. 

Sixth. Internal piles are long, as shown in Fig. 6, and 
it is only the lower portions of such piles that can be re- 
moved by the clamp and scissors, while the hypodermic 
needle is passed up far enough to fill the pile sack from 
bottom to top and destroy it all, including the network of 
enlarged blood-vessels. 

Seventh. Piles cured in this way rarely, if ever, return, 
as the whole of the tumors, and not merely the lower parts, 
are destroyed. 

Eighth. The hypodermic method is always free from 
danger. 

The objections to the knife; to the ligature ; and to the 
clamp and scissors, with the white-hot iron ; are as follows : — 

First. All of these methods are intensely severe ; 
they cause a great deal of suffering; are more or less 
dangerous ; and confine patients to bed for weeks. 

Second. In half the cases applying for treatment at 
the Boston Clinic, the piles don't come down at all, 
but have to be found and treated through the aid of 
the speculum illuminated with an electric lamp, and it is 
impossible for such piles to be reached and destroyed by 
the clamp and scissors or any similar methods. 

Third. As piles are usually long, as shown in Fig. 6, 
it is only their lower portions that can be brought down 
low enough to be grasped by the clamp and cut off with 
the scissors, and for this reason the cure is imperfect. 



402 



INTERNAL PILES. 



Fourth. The cutting methods are usually attempted 
by "omnibus" surgeons — surgeons for everything — who 
have had but limited experience with diseases of the 
rectum ; and their operations often fail, rendering other 
operative measures, with consequent suffering and loss 
of time, necessary. 

Fifth. Stricture of the anus, causing the movements 
of the bowels to be painful and difficult; injuries to the 
muscles through which the patient loses the power to 
control his bowels, and is forced to wear a napkin ; and 
traumatic fissures — painful ulcers more distressing than 
piles themselves — are some of the deplorable misfortunes 
resulting from the clamp and scissors. 

Sixth. The greatest and most important objection to the 
knife, ligature, or scissors, is that people will not submit to 
such methods ; that ninety-nine per cent of the human 
race will carry their afflictions with them to the grave 
in preference to undergoing such frightful operations, 
with all the pain, confinement, and dangers they involve. 
It is a knowledge of these horrible and difficult plans of 
treating diseases that can be cured by mild and painless 
measures, that has intimidated the people and causes them 
to regard with mortal dread any means whatever for the 
cure of piles, fistula, or fissure ; and it is the accounts of 
the bloody and unfortunate operations reaching the eyes 
and ears of the people through the various hospital reports 
that cause them to be seized with fear when considering 
any treatment for diseases of the rectum. For these 
reasons it has been a hard and time-consuming task to 
teach thousands upon thousands who are suffering with 
such diseases that scientific unfoldments have given the 
world painless remedies, and painless appliances for the 




Fig. 5. 

Showing Protruding Piles and their High Attachment. 



403 



404 



ITCHING PILES. 



cure of piles of every variety ; and that the progressive 
physicians and surgeons of the day are using them. 



ITCHING PILES. 

Other names : pruritus ani ; itching of the anus ; ec- 
zema of the anus. 

This is the most aggravating; the most sleep-disturbing; 
the most rest-preventing ; and the most profanity-excusing 
affliction that mankind has ever known ; and unless its 
causes are understood it is almost impossible to cure it. 

Causes. — The predisposing cause is heredity; and any 
one with an inherited tendency to eczema, tetter, salt-rheum, 
or scall — all different names for the same disease — is 
especially liable to have itching piles ; and it is doubtful 
if piles would cause itching at all among those in whom 
no such hereditary tendencies exist. 

The exciting causes of the disease are, piles ; salt-rheum; 
constipation and straining at stool ; alcoholic liquors ; the 
excessive use of tea and coffee ; and pinworms. 

Many cases are found in which there is no appearance 
of piles ; cases in which the lighted speculum, when 
inserted into the bowel, reveals nothing like them ; yet 
in the vast majority of patients that have been treated 
at the Boston Clinic, piles were found ; and in many 
instances the itching ceased forever when the pile tumors 
were destroyed. 

Symptoms. — The disease comes on gradually, as a 
general thing ; the itching usually begins at night soon 
after the person is warm in bed ; may only be felt 
occasionally for months; but its tendency, as time goes 



ITCHING PILES. 



405 



on, is to become more frequent, and also more severe; 
and, sooner or later, the itching gets to be an every-night 
affliction ; as it gets worse and worse the patient often 
becomes worn out for want of rest, and in a half-awake 
and half-asleep condition spends the whole night in 
scratching and breaking one of the commandments. 

Treatment. — Piles of every kind should be destroyed as 
soon as possible, if they exist, and no one can be cured 
until this is done. If the skin around the anus is whiter 
than that of other parts, and has the appearance of being 
bleached by a poultice, it shows that it is bathed and 
macerated in a self-secreting moisture ; and that the moist 
discharge from the skin is caused by salt-rheum. The best 
treatment in such a case — and the one that will always 
cure the salt-rheum and stop the itching if properly carried 
out, is the following : — 

Corrosive sublimate, six grains, 

Water, one pint. 

Mix and take a teaspoonful before each meal. 
At the same time the following should be used every 
night externally : — 

Corrosive sublimate, eight grains, 

Brandy, eight ounces. 
Mix and apply every night to the parts affected, using 
a small sponge for the purpose. In order to hasten the 
cure it is sometimes desirable to use the wash in the 
morning also. The skin around the amis should be kept 
perfectly clean with warm water and soap ; and as the 
disease is very chronic and stubborn in its nature, the 
treatment, both internally and externally, should be con- 
tinued for several months. 

The disease that always causes the moist discharge; 



406 



ITCHING PILES. 



that is the main cause of the terrible itching ; and that is 
known, unfortunately, by four names instead of one ; is 
always cured, finally, by this treatment; but it must be 
remembered that all kinds of intoxicating liquors aggra- 
vate the itching, and also aggravate the doctor who is 
treating the case ; and that it is next to impossible to cure 
a bad case if the patient is determined to drink whiskey, 
brandy, wine, gin, rum, beer, or intoxicants of any kind. 

If the trouble is caused by threadworms the itching is 
generally in the anus or very near it, rarely extending to 
adjacent parts as it does in other cases. 

For this variety take the following : — 
Santonine, fifteen grains, 
Calomel, five grains. 

Mix and divide into five powders and take a powder 
every three hours, commencing early in the morning. 
When all are taken they should be worked off with 
a full dose of castor oil. This treatment is calculated 
to get rid of all the worms, but fearing some might be 
secreted in the folds of the rectum it is well to inject 
the following : — 

Carbolic acid, three drachms, 
Water, one pint. 

Mix and inject it all into the rectum at once, if it will 
hold that much, and after two or three minutes it should 
be forced out, and about a pint of warm water injected 
to rinse out the lower bowel and get rid of all the drug. 
The worms, if any, will be killed. 

There is a form of this disease that has a very obvious 
cause, when properly understood, but the real cause is 
very liable to be overlooked. In this variety there is 
no appearance of salt-rheum — none whatever — and the 




Fig. 6. 
Showing the Hospital Methods of Burning the Stump with a Hot Iron after 
Piles are removed with Scissors. 



407 



408 ITCHING PILES. 

lighted speculum when introduced so as to explore every 
side of the rectum, reveals no piles, and yet there are piles, 
and they cause the itching. Very small, bluish tumors, 
not larger than a pea, are found in the edge of the anus, 
and their covering is so thin and delicate that it is hard to 
tell whether it is skin or mucous membrane. As soon as 
they are destroyed the itching entirely ceases. 

Case XX. (Itching Piles.) 

Mr. D. applied for treatment at the Boston Clinic in 
January, 1893, and had been terribly distressed with the 
itching for ten years ; had tried a multiplicity of remedies ; 
and had been treated by half a dozen doctors, including 
several rectal specialists ; and had received no permanent 
benefit. There was no evidence of salt-rheum ; nothing to 
indicate the flow of moisture characteristic of that disease ; 
and there seemed to be no piles. At his second visit, how- 
ever, I discovered the little blue lumps that were less than 
an average pea, and as I could find nothing else to account 
for the terrible and long-continued itching, I determined 
to destroy them. 

They were too small and undefined to be treated by the 
hypodermic injections, and I therefore treated them with 
a paste made of fresh lime, one ounce ; caustic potash, one 
half ounce ; absolute alcohol, a sufficient quantity to make 
a paste as soft as vaseline. In order to avoid the terrible 
pain that this paste causes, the tumors were touched with 
the strongest carbolic acid ; turned perfectly white : and 
then the paste was applied. Each tumor turned black as 
soon as touched by the paste ; the latter was wiped off 
instantly with a soft cloth, and olive oil put on to stop the 
effect of the paste. Some four or five of the little tumors 
were treated in this way, and the itching never occurred 



ITCHING PILES. 



409 



again. The cure was perfect. The destruction was very 
limited, being confined to a network of small vessels just 
beneath the thin skin in the edge of the anus, and the 
patient was well within ten days. 

If the carbolic acid as here directed is applied freely; 
the paste rubbed off in two seconds ; and the olive oil put 
on immediately ; there will be no pain to amount to any- 
thing. 

Case XXI. (Itching Piles.) 

Dr. J. E. Patrick, 74 Boylston St., Boston, applied for 
treatment at the Boston Clinic in January, 1893, and was 
terribly afflicted with itching piles. There were five or six 
pile tumors of considerable size and all inclined to protrude. 
I operated upon three of them on Friday morning, using 
the hypodermic syringe ; and on the following Monday I 
operated on two or three more, destroying all of them 
within three days. The itching that had lasted for years 
entirely ceased after the second operation, and he has been 
free from trouble ever since. 

Case XXII. (Itching Piles.) 

Mr. H., aged 40 ; fair complexion with beautiful skin ; 
applied for treatment at the Boston Clinic June, 1897. He 
stated that he had had itching piles for several years ; that 
every effort to get any permanent benefit had been a 
failure ; and that the trouble had increased until life had 
become a burden. An examination with the lighted rectal 
speculum revealed no piles whatever ; the skin was broken 
out with an eruption extending several inches in every 
direction from the anus ; there was a bleached appearance 
of the skin surrounding the anal orifice, due to a gradual 
flow of moisture ; and the poor fellow had almost torn the 
skin to pieces with his finger nails. This was a pure and 



4io 



ITCHING PILES. 



simple case of salt-rheum except that it had been aggra- 
vated by intoxicating liquors. The following was given 
internally for two months : — 

Corrosive sublimate, six grains, 
Water, one pint. 

Mix and take a teaspoonful before each meal. At the 
same time the following mixture was applied externally : — 
Corrosive sublimate, eight grains, 
Brandy, one half pint. 

Mix and apply night and morning with a small sponge, 
refraining from the use of ointments of every kind and 
keeping the parts clean with soap and water. Within five 
or six weeks he was entirely well, the skin being free from 
eruption, and also free from itching. 

Case XXIII. (Internal and Itching Piles.) 

Mrs. Emma H. Arnold, music teacher, Linden, Mass., 
entered the Boston Clinic for treatment in January, 1893. 
She had been suffering for years from internal piles, and 
also from terrible itching. The Daily rectal speculum, 
carrying a small electric lamp in its wall, was introduced. 
When the piles were found they were destroyed by filling 
each pile sack with a solution of phenic acid, a hypodermic 
syringe with a very long needle being used for the purpose. 
The operations with the syringe were painless, as they 
usually are, and the piles were all destroyed in two or 
three weeks. 

To get rid of the eczema around the anus the following 
was given : — 

Corrosive sublimate, six grains, 
Water, one pint. 

Mix and take a teaspoonful before each meal. At the 
same time the following was used externally : — 



ITCHING PILES. 411 

Corrosive sublimate, eight grains, 
Brandy, eight ounces. 

Mix and apply night and morning to the parts affected, 
using a small sponge for the purpose. She was entirely 
well within a month and has had no return of the piles nor 
the itching. 

Case XXIV. (Internal Piles.) 

George E. Messer, 73 Haverhill St., Boston, age 56, 
entered the Boston Clinic January, 1893, with internal piles 
from which he had suffered for many years. The pile 
tumors were easily found by means of the author's speculum, 
which is always lighted with a tiny electric lamp ; a hypo- 
dermic syringe having a long needle was used ; a pile sack 
was filled with a solution of pJienic acid, the operation being 
painless ; two other tumors were treated in the same way 
on the corresponding day of the following week, and so on 
until all were destroyed. He was entirely cured in three 
weeks and attended to his usual business during the treat- 
ment. 

Case XXV. (Protruding Piles. A terribly bad case.) 

Alba Woods, engineer, North Lunbridge, Vt, age 49, 
entered the Boston Clinic as a patient in January, 1893, 
and was suffering from the worst form of protruding piles 
imaginable. The tumors were extremely large, and in 
order to keep them from coming down he was compelled 
to wear a pile truss that was held in position by straps over 
each shoulder, like suspenders. I used a hypodermic 
syringe and commenced the treatment by filling one of the 
large tumors with a solution of phenic acid y the operation 
being painless; and on the corresponding day of the 
following week two other tumors were treated in exactly 
the same way, and so on until all were destroyed, the cure 



4 I2 ITCHING PILES. 

being completed within three or four weeks. He attended 
to his usual business while being cured. 

Case XXVI. (Protruding and Bleeding Piles.) 

Charles F. Tenney, night watchman at the State House, 
Boston, age 50, entered the Boston Clinic as a patient in 
April, 1893. He had large protruding piles from which he 
had suffered for fifteen years or more. I used a hypodermic 
syringe and filled two of the pile sacks with a solution of 
phenic acid which caused their total destruction. On the 
same day of the following week I treated two other tumors 
in the same way ; he was entirely cured within two or 
three weeks, all the operations being painless, and he 
attended to his usual duties. 

Case XXVII. (Protruding Piles.) 

Samuel Vaughan, letter carrier, 2 161 Washington St., 
Boston, age 56, entered the Boston Clinic in April, 1893, 
with very bad protruding piles from which he had suffered 
for twenty-five years. Although they were exceedingly 
large, I destroyed them all in two or three treatments, and 
he has been free from the disease ever since. A hypoder- 
mic was used ; two pile sacks were filled with a solution of 
phenic acid, which was painless ; and on the same day of 
the next week two other piles were treated in the same 
way, and so on until all were destroyed. He attended to 
his business during the treatment. 

Case XXVIII. (Protruding Piles.) 

Professor Alex. Mirault, 486 Fletcher St., Lowell, Mass. 
age 49, entered the Boston Clinic in May, 1893, with large, 
protruding piles, from which he had suffered for more than 
twenty years. I used a hypodermic syringe and filled two 
of the pile tumors with a solution of phenic acid, the opera- 
tion being painless. In one week from that day I treated 



ITCHING PILES. 413 

the rest of the tumors the same way, and he was well 
within two weeks from the time he first entered the clinic. 
Case XXIX. (Protruding Piles.) 

Mrs. Helen Broughton, 103 Trenton St., East Boston, 
became a patient in the Boston Clinic in June, 1893, and 
had suffered with protruding and bleeding piles for more 
than twenty years. The tumors were large and numerous. 
I used a hypodermic syringe and filled one of the pile 
sacks with a solution of phenic acid, the operation being 
painless, as usual ; and on the same day of the next week 
I treated another, and so on until all were destroyed. She 
attended to her usual duties all the time and has been free 
from the trouble ever since. 

Case XXX. (Bleeding Piles. A terrible case.) 
H. C. Thrasher, chairmaker, Erving, Mass., age 50, 
came to the Boston Clinic in October, 1894, and was the 
worst case of bleeding piles I had ever seen. Though in 
good flesh, he was pale as a spook from loss of blood, and 
was very weak. The piles were of immense size, and 
blood spurted in several directions from one of the large 
tumors. As I wished to stop the terrible flow of blood 
I injected six drops of solution of subsulpliate of iron into 
the tumor that was spurting blood all over the table. It 
stopped the bleeding instantly and destroyed the entire 
tumor within a week. On the same day of the following 
week I destroyed two large tumors by filling the pile sacks 
with p/ie fiic acid solution, using a hypodermic syringe, and 
the patient was entirely cured within three or four weeks. 
The operations were all painless except when the solution 
of iron was injected. 

Case XXXI. (Protruding Piles. A very bad case.) 
Robert Buttervvorth, 11 South Whipple St., Lowell, 



414 



ITCHING PILES. 



Mass., entered the Boston Clinic in November, 1894, and 
was suffering with protruding and bleeding piles of the 
worst form. The tumors had been growing for twenty- 
five years, and were of immense size. I operated upon 
two of them immediately with a hypodermic syringe, 
filling the pile sacks with a solution of phenic acid. They 
were entirely destroyed within a week ; others were treated 
in the same way on the corresponding day of the next 
week, and so on until all were destroyed. He was cured 
within three weeks ; all the operations were painless ; he 
attended to business while being cured ; and is now free 
from the disease. 

Case XXXII. (Internal Piles with Bleeding.) 
Frank P. Piper, Laconia, N. H., came to the Boston 
Clinic in 1895, with a number of painful pile tumors that 
had troubled him for several years. I used the hypoder- 
mic syringe and filled two of the pile sacks with a solution 
of phenic acid ; the operations were painless ; and the 
tumors were destroyed within a week. The others were 
treated in the same way, two tumors being destroyed each 
week; and he was thoroughly cured in three weeks, 
attending to his usual business while being cured. 
Case XXXIII. (Protruding Piles. Very bad.) 
Mrs. Emma F. Hill, 30 Church St., Watertown, Mass., 
came to the Boston Clinic in January, 1897, with protrud- 
ing and bleeding piles in an aggravated form, the tumors 
being very large. I used a hypodermic syringe and filled 
one of the pile sacks with the solution of phenic acid, the 
operation being painless. The other pile tumors were 
destroyed in the same way, two being treated each week 
until all were destroyed. She attended to her usual duties 
during the treatment and is now free from the disease. 



PAINLESS TREATMENT — HOW DISCOVERED. 



415 



Case XXXIV. (Protruding Piles.) 

Mrs. D. C. Elliott, Penacook, N. H., came to the Boston 
Clinic in April, 1897, w i tn protruding piles of many years' 
duration. She was in a hurry to return home, and I 
treated all the piles she had before she left the table. 
I used a hypodermic, filling every pile sack with a solution 
of phenic acid ; the operations were almost painless and 
she was entirely well within ten days. 

Case XXXV. (Protruding Piles.) 

Edward Griffith, banker, 35 Mount Vernon St., Boston, 
Mass., age 49, entered the Boston Clinic in July, 1898. 
He had been suffering for many years with protruding 
piles, the tumors being large and very much inclined to 
protrude. Sometimes they would come down a dozen 
times per day and have to be pushed back. I immediately 
treated two of them with a hypodermic syringe, filling 
each pile sack with a solution of phenic acid, the opera- 
tions being painless. The other tumors were treated in 
the same way, two being destroyed each week, and he was 
permanently cured within three weeks. He attended to 
business while being cured. 



HOW THE PAINLESS TREATMENT WAS 
DISCOVERED. 

In the early seventies I was practising medicine and 
surgery in Salina, Kansas. A child was brought to my 
office with a purple tumor upon its right cheek, and the 
parents wanted it removed, if possible, without leaving 
any scar. I knew of no way in which to get rid of it 
except to cut it out with the knife, and although it was 



41 6 PAINLESS TREATMENT — HOW DISCOVERED. 

not larger than a small cherry, I knew the knife operation, 
at best, would leave a scar. I consulted a new work on 
surgery by S. D. Gross, and found a beautiful description 
of the tumor that was disfiguring the cheek. Professor 
Gross advised the removal of all such tumors by injecting 
into them a few drops of subsulpJiate of iron, known as 
Monsel's solution. I was assured by Gross that such 
treatment was free from danger; and that the tumors 
would be destroyed within a week, leaving but little, if any 
scar. This was called a venous tumor by Gross ; looked like 
a venus-pile tumor ; and like a pile, consisted of a network 
of blood-vessels. I pushed a hypodermic needle into the 
centre of the tumor and forced out about four drops of the 
iron solution. The structure immediately increased in size 
a little; became harder; and I feared I had injected too 
much of the drug ; but after the patient recovered from 
the chloroform there was no distress to speak of. The 
tumor was entirely gone within a week; the sound flesh 
was uninjured ; and the little girl's face was not disfigured 
at all by the operation. Every trace of the tumor was 
removed. 

This experience led me to think seriously of trying 
the same treatment upon a case of piles, my principal 
encouragement being the similarity of the two in appear- 
ance and structure. A few months later a man came into 
the office with a protruding pile tumor that had been 
coming down frequently and causing him a great deal 
of annoyance. 

Of course I felt that I was going upon untrodden and some- 
what dangerous ground, but all the reason I could exercise 
favored the idea of injecting into the pile tumor the same 
kind of solution that had given such perfect satisfaction in 



PAINLESS TREATMENT — HOW DISCOVERED. 4x7 

destroying the tumor upon the face, and I decided to try- 
it. I injected six drops of the iron solution into the large 
pile tumor, and it caused severe smarting pain for about 
fifteen minutes. When the smarting ceased there was but 
little if any pain left, and the patient attended to his usual 
business on the following day. The pile was entirely de- 
stroyed within a week. I saw at once that the success of 
the treatment depended upon a beautiful principle, namely : 
The coagulation of the blood and destruction of every 
blood-vessel in the pile sack, and felt sure that it would 
always succeed. // ahvays lias. I realized that I had 
made a great and valuable discovery ; that millions would 
rejoice to learn of such a quick and bloodless way in which 
to get rid of their afflictions ; and that the old torturing 
methods would be abandoned forever. A great many other 
cases were cured by injecting the iron solution into the pile 
tumors. My brother, Dr. S. J. Daily, who was practising 
with me, operated upon many cases ; the treatment was 
always a perfect success ; and it was through this discovery 
that he and I both became specialists in Diseases of the 
Rectum. He established himself in Kansas City, and the 
Governor of Kansas was one of his distinguished patients to 
be cured by the new method. I opened offices in Cincinnati. 
There never has been, and there never can be, a more 
thorough treatment for piles than spurting a few drops of 
subsiilphate of iron into the pile sack, as a pile cannot live 
a minute after it is treated in this way. When, in 1872, I 
was told by S. D. Gross, in his voluminous work on surgery, 
to destroy the unsightly tumor upon the child's cheek by 
injecting it with the iron solution, a soul-thrilling thought 
entered my brain, and I exclaimed : " Great heavens ! That 
treatment will cure every case of piles on earth." 



4i8 



PAINLESS TREATMENT — HOW DISCOVERED. 



After an experience of a few months, in which I used 
the iron treatment about twenty times, I found I could 
avoid almost all the smarting pain the iron solution gave 
if I injected a third of a grain of morphine into the arm 
a few minutes before each operation. 

The iron solution is superior in some respects to every 
other method of treatment, the only objection to its use 
being the smarting pain that lasts for fifteen minutes after 
each operation. Its advantages over other methods by 
injection are as follows : — 

First. If a pile tumor is spurting blood in every direc- 
tion, it stops the bleeding instantly and forever. 

Second. The solution destroys all the blood-vessels from 
the bottom to the top of the pile tumor, but not being a 
caustic, it only destroys enough of the pile sack to allow 
its contents to escape, the opening in the mucous mem- 
brane being comparatively small. 

Third. Nothing can be more thorough than its action 
in destroying the pile veins and preventing a return of the 
disease. 

I found in practice, however, that the fifteen minutes of 
pain that always followed each operation was a serious 
objection to the iron treatment; that many persons were 
opposed to the use of morphine in any way; that some 
were frightened when told it was necessary ; and that the 
pain was a constant source of trouble and anxiety. This 
led me once more into the realm of investigation and dis- 
covery ; and after a year or more of study, research, and 
experimenting, I worked out and perfected the painless 
treatment that I have used ever since, and that I have 
employed almost wholly since opening the Boston Clinic 
in 1892. 



HOW TO PREVENT PILES, FISTULA, AND FISSURE. 4I g 

Dr. Milton W. Mitchell, of Jacksonville, 111., also 
commenced using the hypodermic syringe in the early 
seventies, and made a business of curing piles in that way, 
but what drug or solution he injected I do not know, as his 
method has never been published that I am aware of. 

From 1875 to 1879 I did an immense business in rectal 
surgery at Youngstown, Ohio, and had a clinic there in 
which I taught a great many doctors the new and painless 
methods of operating upon hemorrhoids ; and it was prob- 
ably in this way that a man by the name of BrinkerhofT, 
learned the method as I used it at that time. He travelled 
over the United States and sold the discovery to a great 
many doctors, and the formula that he gave them is known 
to-day as the " BrinkerhofT treatment." It is quite severe 
as compared with my present treatment. 



HOW TO PREVENT PILES, FISTULA, AND 
FISSURE. 

It is highly probable that ninety per cent of all the cases 
of piles ; a very large per cent of the cases of fistula in ano 
and fistula iit recto ; and at least ninety-nine per cent of 
the cases of anal fissures are caused by constipation and 
severe straining at stool ; and therefore, any person suffer- 
ing from constipation in an aggravated form is warranted 
in making many sacrifices in order to get rid of it, as it is 
almost sure, sooner or later, to develop piles and other 
troubles. 

The causes of constipation are very obvious ; and unless 
they are studied and avoided by the patient no treatment 
can be successful. The disease, if it is a disease, is caused 



420 



CONSTIPATION. 



in almost all cases by the use of food that is so highly- 
nutritious that but little of it is necessary to nourish the 
body ; and as such food only occupies a very small part of 
the intestinal canal — frequently not more than one-tenth 
of it — the bowels have scarcely anything to act upon. 

The intestines being from twenty-five to thirty feet long, 
are capable, when the stomach is included, of holding 
many pounds of food and liquid; and if the amount 
habitually taken by a person is sparingly nutritious he is 
compelled to eat enough of it during the three meals 
per day to keep his bowels pretty well filled; and when 
stimulated throughout their entire course by the presence 
of fruits and vegetables in abundance — articles of great 
volume and little nutrition — they are kept normally 
energetic in their muscular action; their secretions are 
correspondingly healthy and abundant, and the bowels 
feel, as it were, that they have something to do ; and when 
a diet of fruits and vegetables is substituted for one with 
meats, they awake from months or years of torpor ; their 
bountiful secretions are mixed with the fully digested 
food ; the whole mass of refuse, soft as soft dough, easily 
slips by the numerous curves in its downward course to 
the rectum ; arrives every morning at that discharging 
depot; and as the stools are always soft and wet instead 
of dry and hard; large and dough-like instead of small 
and lumpy ; the bowels always move easily and there is 
scarcely anything to occasion diseases of the rectum. 

CONSTIPATION. 



When a person is always quarrelling with his bowels 
for being constipated ; always coaxing them with physic ; 



CONSTIPATION. 4 2 1 

always hunting for something that no one has ever found, 
and no one ever will find — a medicine that will cure con- 
stipation — he is always a meat-eater. 

The way in which meat causes constipation is this : 
Every person needs a certain amount of nutrition to 
nourish the body; and as soon as that amount is taken 
into the stomach in the form of food the appetite is satis- 
fied. Meat is ten times more nutritious than an equal 
amount of fruits and vegetables ; and when it is a part of 
the meal, as it usually is, it is the first thing eaten ; it 
stops the hunger ; but little, if any vegetables or fruits 
are desired ; and the volume of the food eaten is so deplor- 
ably small that there is scarcely anything to stimulate 
the bowels and cause the digested food to be mixed with 
enough intestinal secretions to make its winding passage 
to the rectum easy. 

Man is not a carnivorous animal, and therefore, is not 
compelled to eat meat ; his weight, health, and vigor of 
body can be maintained, and his appetite for food satisfied 
as well without meat as with it ; but in changing from a 
meat diet to one of fruits and vegetables there may be 
a craving for meat until a person adapts himself to the 
change, and learns the importance of eating a great deal 
more food. Meat is all right for persons not subject to 
constipation, but it aggravates and multiplies the afflictions 
of those who are. 

A positive cure for constipation can be given in seven 
words, and here it is : Eat no meat, eggs, cheese, nor fish. 
It is unnecessary to urge people to eat a great deal of 
fruits and vegetables, as this becomes a necessity as soon 
as they cease to eat meat, eggs, cheese, and fish. 

Millions of people are as constipated as an Indian-tobacco 



422 



CONSTIPATION. 



sign unless they take physic ; they have been eating physic 
for years and their bowels will not move without it. Even 
such desperate persons can all be cured when they fully 
realize that it is the great volume of food and drink they 
need, and not food that is rich in nutritive properties ; and 
although they must have a given amount of nutrition, the 
more it is mixed up and diluted with materials that are not 
nutritious, the greater will be the amount of refuse to go 
through the bowels ; the greater will be their muscular 
activity; the greater will be their secretions; the better 
will be the action of the liver and all other organs ; the 
softer and more frequent will be the stools ; the more 
healthful and less stupid will become the individual ; and 
physic will never be needed. 



RUPTURE. 423 



RUPTURE. 

Other names : hernia ; a breach. 

This is a disease in which the muscles stretch or spread 
apart so as to allow some of the contents of the abdomen 
to be forced out through the abdominal wall. 

The protruding parts are called a tumor ; usually include 
an elbow of a small intestine ; are enclosed by a sack con- 
sisting of the membranous lining of the abdominal cavity ; 
and the point at which the tumor is found determines the 
name of the hernia. 

It is customary to divide hernia in two distinct ways : 
First, in regard to location, as inguinal, femoral, and um- 
bilical; and second, according to the condition of the pro- 
truding parts, as reducible, irreducible, and strangulated. 

When proper pressure and manipulation with the fingers 
cause the tumor to disappear entirely it is called reducible ; 
when every possible effort to push the protruding parts 
back into the abdomen fails it is called irreducible ; and 
when the intestine and other folds are embraced so firmly 
by the abdominal ring through which they have slipped as 
to obstruct the bowels and arrest the circulation in the pro- 
truding parts it is called strangulated. 

Causes. — The predisposing cause is man's erect position, 
through which the weight of the stomach and bowels is 
thrown upon the lower part of the abdomen. 

The exciting causes are pregnancy ; hard and prolonged 
labor in childbirth ; straining at stool ; wrestling ; heavy 
lifting ; violent physical efforts of any kind ; playing on 
wind instruments ; and glass-blowing. 

Symptoms. — A tumor, usually small at first, appears in 



424 RUPTURE. 

the region of the right or left groin, or the navel; is 
attended with more or less pain ; the discomfort and size 
of the tumor are increased by coughing, sneezing, singing, 
blowing, or lifting ; and in most cases the protruding parts 
yield to moderate pressure by the fingers and return to the 
cavity of the abdomen. 

Treatment. — The palliative treatment of hernia consists 
in pushing back the protruding parts ; closing the opening 
with a suitable truss ; wearing it constantly except when 
the patient is in bed ; avoiding all physical exertions cal- 
culated to aggravate the trouble ; and, if possible, prevent- 
ing the bowel from protruding again. 

When pushing back the tumor it is best to have the 
patient on his back, and it is often of the greatest impor- 
tance to elevate the hips by placing two or three pillows 
under them. Children must be amused or quieted so as to 
prevent the screams and struggles that have a provoking 
tendency to force the bowel out ; and it may be necessary 
to give ether. 

By keeping a child in a warm bath for fifteen or twenty 
minutes, the muscles often become so relaxed that the 
tumor easily disappears under pressure with the fingers. 

The Knife Operation. 

In strangulated hernia, and in cases attended with ad- 
hesions so the protruding structures cannot be pushed 
back, there is no remedy except the knife operation ; but, 
fortunately, those requiring the knife are comparatively 
few ; a very large majority of cases are reducible ; the 
bowel can be held back by a suitable truss ; and most per- 
sons are curable without cutting, with but little if any pain, 
and without loss of time from business. 



RUPTURE. 425 



The Injection Method. 

The cure of rupture without a knife operation is one of 
the most beautiful and beneficent discoveries of this age, 
and consists in using a hypodermic syringe in such a way 
as to force a few drops of liquid into the muscular tissues 
surrounding the rupture ; wearing a truss so as to prevent 
protrusion again ; and repeating the injections once per 
week until the patient is entirely cured. 

Nothing can be more rational and scientific than the 
principles involved in curing hernia by injections. The 
solution injected irritates the flesh surrounding the open- 
ing ; nature sends an extra amount of blood there to repair 
the injury; the elements of repair carried by the blood to 
the seat of the rupture are the same as those that cause 
a wound to heal ; and all the flesh in the locality of the 
opening becomes hard and firm, somewhat like the scar 
tissue resulting from a wound ; and as such fibrous tissue 
is unyielding, protrusion is impossible, and the patient is 
cured. 

This is the way in which ruptures are cured at the Boston 
Clinic, and the author feels fully warranted in saying this : 
All cases in which the protruding parts can be held back by 
a truss can be thoroughly cured by injections, and the treat- 
ment is free from danger. 



INDEX 



Appendicitis, suppurative, 66. 
Ascites, 76. 
*Ague, 93. 
Asthma, 163. 

bronchial, 163. 

spasmodic, 163. 

hay, no. 
Apoplexy, 188. 
"A stroke," 188. 

* Angina pectoris, 197. 
Acute coryza, 224. 
*A girdle, 266. 
Amenorrhcea, 273. 
*Acne, 316. 

sebacea, 313. 
*vulgaris, 316. 
punctata Nigra, 339. 
Anthrax, 340. 

Black vomit, 1 14. 
Bronchitis, chronic, 15 1. 

secondary, 151. 
Brain, hemorrhage of, 188. 

congestion of, 195. 
Bleeding from a cut, 206. 

*fro?n pulling a tooth, 206. 

*from nose, 207. 

from lungs, 166. 

* Bloody flux, 51. 
*Bronchocele, 212. 
Bright's disease, acute, 246. 
Biliary calculi, 245. 
Black-headed worms, 339. 



Clothing, 22. 

* Constipation, 37. 
Cholera, 55. 

epidemic, 55. 
autumnal, no. 
Asiatic, 55. 
spasmodic, 55. 
malignant, 55. 
^infantum, 43. 
*morbus, 58. 
* bilious, 58. 
* English, 58. 
^sporadic, 58. 
Colitis, 51. 

ulcerative, 51. 

* Catarrh, 214. 

* chronic nasal, 214. 

of bile ducts, 223. 

acute nasal, 224. 

of the mouth, 150. 

contagious, 153. 

acute gastric, 83. 

intestinal, 62. 

chronic gastric, 78. 
Catarrhal enteritis, 62. 

nephritis, 241. 

stomatitis, 150. 
*Cardialgia, 72. 

* Chills and fever, 93. 
Cerebro-spinal meningitis, 106. 

fever, 106. 
typhus, 106. 
Chicken-pox, 142. 

431 



432 



INDEX. 



Cancer, gastric, 75. 

of the stomach, 75. 

water, 146. 
Cancrum oris, 146. 

* Croup, membranous, 169. 

*true, 169. 

* spasmodic, 181. 

* false, 181. 

* Croupous Laryngitis, 1 69. 

* Child-crowing, 1 81. 
Cerebral congestion, 195. 

hyperemia, 195. 

* Colic, intestinal, 61. 

* infantile, 205. 

* cramp, 210. 
hepatic, 245. 

* Constipation, 37, 420. 
Coryza, chronic, 214. 

acute, 224. 
Cephalodynia, 221. 
Cold in the head, 224. 
Coup de soleil, 261. 
Chorea, 265. 

Conception, when most liable, 310. 
Caked breasts and sore nipples, 

3"- 

Congestion of the skin, 321. 

* Chalk-like deposits of the skin, 336. 
Comedo, 339. 

Carbuncle, 340. 

Chafing, 343. 

Clavus, 346. 

Consumption of throat, 174. 

of lungs, 174. 
Corns, 346. 

Diet, 20. 
"Dyspepsia, 31. 

* atonic, 31. 

"intestinal, 47. 

drunkard's, 64. 

*chronic, 78. 
""■Diarrhoea, acute, 62. 
"Dysentery, acute, 5 1. 



Dropsy, abdominal, 76. 

peritoneal, 76. 
"Diphtheria, 184. 
Diabetes insipidus, 242. 

mellitus, 243. 
Dysmenorrhoea, 275. 
Dandruff, 313. 
Diseases of rectum and anus, 352. 

Exercise, 25. 
Erysipelas, 136. 
Erysipelatous dermatitis, 1 36. 
"Epistaxis, 207. 
Epilepsy, 250. 
" Encysted tumors, 318. 
Excessive sweating, 319. 
Erythema simplex, 321. 
"Eczema, 325. 

"chronic, 330. 
Erythema intertrigo, 343. 

Fevers, 89. 

general management of, 91. 

^intermittent, 93. 

swamp, 93. 

malarial, 93. 

remittent, 97. 

typho-malarial, 97. 

bilious, 97. 

bilious remittent, 97. 

marsh, 97. 

typhoid, 101. 

enteric, 101. 

gastric, 8^, 101. 

nervous, 101. 

abdominal typhus, IOI. 

autumnal, 101. 

simple, continued, 109. 

irritative, 109. 

ephemeral, 109. 

bilious typhoid, 112. 

relapsing, 112. 

famine, 112. 

ship, 113. 



INDEX. 



433 



Fevers, contagious, 113. 

jail, 113. 

petechial, 1 1 3. 

typhus, 113. 

spotted, 113. 

exanthematic typhus, 113. 

lung, 176. 

hay, no. 

rose, no. 

yellow, 114. 

bilious malignant, 114. 

Mediterranean, 114. 

cerebro-spinal, 106. 

cerebro-spinal typhus, 106. 

sailor's, 114. 

pernicious, 1 1 7. 

congestive, 1 17. 

malignant remittent, 1 17. 

malignant intermittent, 1 1 7. 

scarlet, 121. 

rheumatic, 217. 

thermic, 261. 

winter, 176. 
Febris recurrens, 1 12. 
Febricula, 109. 
Favus, 323. 
Freckles, 335. 
Flesh-worm disease, 342. 
*Fistula, in ano, 360. 
* recto, 360. 

causes of, 361, 365. 

how to prevent it, 419. 

^complete, 362. 

*blind, internal, 364. 

*blind, external, 364. 

^complete, internal, 364. 

^complete, external, 364. 

*horseshoe, 364. 

persons most liable to, 365. 

treatment of, 370. 

the elastic cord in, 371. 

advantages of cord in, 372. 

the knife operation in, 374. 

failures of knife in, 376. 



Fistula, cases in, 378-382. 

*recto-vaginal, 383. 
cases in, 384. 
* Fissure of the anus, 385. 

causes of, 385. 

how to prevent it, 419. 

treatment of, 386. 

cases of, 3S8. 

Gastric carcinoma, 75. 
*Gastralgia, 72. 
* Gastrodynia, 72. 
Gastritis, acute, 86. 

chronic, 78. 

toxic, 87. 
Glossitis, 148. 
"Grip," 153. 

* Goitre, 212. 
Gin liver, 226. ' 
Gout, 227. 

Gall stones, 245. 

Hygiene, II. 
Haemoptysis, 166. 
Hemorrhage, pulmonary, 166. 
*Hemicrania, 191. 

* Headache, sick, 191. 

* blind, 191. 

* bilious, 191. 

* common, 201. 

* Heart, palpitation of, 202. 

* irritable, 202. 
^fluttering, 202. 

* Heartburn, 31. 
Heredity, 229. 
Hereditary influences, 229. 
Hepatic calculi, 245. 
Hysteria, 258. 
Hysterics, 258. 
Heat stroke, 261. 
Heat exhaustion, 261. 
*Herpes, Zoster, 266. 
Hooping cough, 161. 
Hydrosis, 319. 



434 



INDEX. 



Hyperidrosis, 319. 
*Herpes circinatus, 322. 
Hives, 337. 

* Hemorrhoids, 39 1. 
*Hemia, 423. 

* Indigestion, 31. 

* acute, 83. 

^intestinal, 47. 
Influenza, 153. 
Intellect, inheritable, 236. 

* Intestinal parasites, 68. 
Insolation, 261. 
Insanity of muscles, 265. 
*Itch, 333. 

*barber , s, 344. 

* Ingrown toenails, 348. 

Jaundice, 223. 

catarrhal, 223. 

Kidneys, congestion of, 

inflammation of tubes of, 246. 

La Grippe, 153. 

Laryngitis, acute catarrhal, 172. 

catarrhal, 172. 

^spasmodic, 181. 
Larynx, tuberculous inflammation of, 



Laryngeal phthisis, 174. 
Lumbago, 221. 
Lumbodynia, 221. 
Leucorrhoea, 279. 
Labor, chloroform and ether in, 
Lentigo, 335. 

Mind, effects of, on body, 27. 
Measles, 125. 

German, 141. 

French, 141. 

false, 141. 
^Migraine, 191. 
Mumps, 167. 
* Melancholy, dyspeptic, 196. 



[174. 



308. 



Mental characteristics, 235. 
Menstruation, 267. 

suppression of, 273. 

excessive, 271. 

painful, 275. 
Menorrhagia, 271. 

Mother's mind, effects on unborn, 289. 
^Morning sickness, 299. 

* Neuralgia, 253. 

* of the face, 253. 

^ of the head and neck, 253. 
^ of the neck and arm, 253. 

* between the ribs, 253. 
^intercostal, 253. 

*of stomach, 72. 

* of hip {sciatica), 254. 
Noma, 146. 

*A T ervous exhaustion, 263. 
* Neurasthenia, 263. 

* Nervous prostration, 263. 
Nettle-rash, 337. 

Proctitis, 82. 
Pleurisy, 156. 
Pleuritis, 156. 
Pertussis, 161. 
Parotiditis, 167. 
* Pneumonia, 176. 
*pleuro, 176. 
* Pneumonitis, 176. 

* Putrid sore throat, 184. 
Pulmonary hemorrhage, 166. 
Pleurodynia, 221. 
Polyuria, 242. 
Perityphlitis, 66. 
Polydipsia, 242. 
Pregnancy, 284. 

signs of, 285. 
management of, 288. 
hygiene of, 289. 
constipation in, 302. 
piles in, 303. 
enlarged veins, 303. 



INDEX. 



435 



Pregnancy, duration of, 306. 
sleep in, 304. 
clothing in, 304. 
coition in, 305. 

* morning sickness, 299. 

* nursing, sore mouth in, 305. 
sex of offspring, 307. 

signs of labor in, 307. 
Pityriasis, 313. 
* Pyrosis, 31. 
Porrigo favosa, 323. 
Pork worm, 342. 
Poisons, 350. 

* Piles, 391. 

causes of, 391. 

how to prevent them, 419. 

* external, 393. 
*thrombotic, 393. 

cases in, 394. 

* cutaneous, 393. 
^internal, 397. 

cases in, 410. 
*bleeding, 397. 
^protruding, 397. 
treatment of, 398. 
the hypodermic in, 399. 
objections to cutting in, 401. 
* itching, 404. 

treatment of, 405. 
cases in, 407. 
painless treatment in, 414. 
* Protrusion of the bowels, 355. 
^Prolapsus ani, 355. 

* Pruritus ani, 404. 

Quinsy, 159. 

^malignant, 184. 

* Round worms, 71. 
Rectum, inflammation of, 82. 
Rectitis, 82. 

Rectum, catarrh of, 82. 
Rubeola, 125. 
Roseola, epidemic, 141. 



* Rheumatism, acute articular, 2 1 7. 

*inflammatory, 217. 

muscular, 221. 
Renal hyperemia, 241. 
*Ringworm, 323. 

* of the body, 322. 

* crusted, 323. 

* Rectum, protrusion of, 355. 
* Rupture, 423. 

*Summer complaint, 42. 
Stimulants, effects of, 16. 
Smoking, 18. 
Stomach colic, 72. 

* Stomach, cramp or spasm of, 72. 
Spotted fever, 106. 

Synocha, 109. 
Scarlatina, 121. 
Scarlatto, 121. 
Small-pox, 129. 
Saint Anthony's fire, 136. 
Stomatitis, aphthous, 143. ' 

croupous, 143. 

follicular, 143. 

vesicular, 143. 

diphtheritic, 147. 

ulcerative, 147. 

parasitic, 145. 

gangrenous, 146. 

catarrhal, 150. 

simple, 150. 
Stitch in the side, 156. 
Snake-bite, 199. 
Skin, congestion of, 321. 

^chalk-like deposits in, 336. 
Spitting of blood, 166. 
Sore throat, 172. 
*Sore lips, 209. 
Sunstroke, 261. 
Spinal irritation, 263. 

* Shingles, 266. 

Saint Vitus's dance, 265. 
Suppression of menses, 273. 
Seborrhcea, 313. 



/VK. 






436 INDEX. 



Sebaceous tumors, 318. 
* Salt-rheum, 325. 
Spirituality inheritable, 236. 
Sex of offspring, 307. 
^Scald-head, 325. 
*Scabies, m. 

The skin, 23. 
Tea and coffee, 13. 
Tobacco, 17. 

* Tapeworm, 68. 

To prevent pitting in small-pox, 134. 
Tuberculous inflammation of larynx, 
The rose, 136. [174. 

Thrush, 145. 
Tonsilitis, acute, 159. 

* Tonsils, enlarged, 214. 

* Thick neck, 212. 

* Throat, ulceration in, 2 1 3. 
Torticollis, 221. 

The " whites," 279. 

Throat, consumption of, 174. 

* Tic-douloureux, 253. 

* Tinea circinata, 322. 

*favosa, 323. 

* Tetter, 325. 
Trichinae, 342. 

spiralis, 342. 



X^^u 



13 



Tongue, inflammation of, 148. 

Ulcer, gastric, 86. 

perforating, 86. 

peptic, 86. 

chronic gastric, 86. 
Urine, 248. 
Urticaria, 337. 

Vaccination, 127. 
Variola, 129. 
Varicella, 142^ 
Varus, 316. 

* Verruca, 345. 

White mouth, 145. 

Whooping cough, 161. 

Water cancer, 146. 

Winter cough, 151. 

Wry neck, 221. 

Womb, displacements of, 282. 

*Wens, 318. 

* Warts, 345. 



Yellow Jack, 114. 
*Zono, 266. 



